Appointment Form (Click My Calendar)

**When contacting me please realize priority will be given to clients who thoroughly fill out this form and to clients who "book in advance".**

I am asking personal information for my SAFETY ONLY. I will always be professional, discreet and all of your information will be kept strictly confidential.

The most important information to me is your place of business. I need to know this for my screening and to "secure my continued work" as an Exclusive Companion. If you don't feel comfortable releasing this information, I do understand and I would be happy to work with you.

* = required field

* First Name:
* Last Name:
* E-mail address:
* Cell phone number:
* Company name:
* Company address:
* Company phone: (main line)
* Desired Date(s):
* City:
* Incall/Outcall:	Incall Outcall
* Package:

Please specify your Special Requests and give me a brief introduction of how I may better accomodate you: Love

Thanks for taking the time to fill out this form... it will definitely be worth your effort and I will reward you in more ways than one... smile

For "last minute" appointments or if you are not comfortable completing this form,
please e-mail me at:

Porscha@santacruzsecrets.com

Respectfully,

Porscha