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kinkybettyb.com
Betty Brown
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New Client Application Form
New Client Application Form
Page Title
Page Title
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Legal Name
*
First
Middle
Last
Introduce yourself and specify what type of appointment you're looking for
*
Appointment Location
*
Incall
Outcall
Incall means you come to me (deposit for the room required). Outcall means I come to you (deposit for travel expenses required)
If appointment is for outcall or a public date what is your location (City, State)?
Desired appointment length in hours
Selected Value:
0
Desired date of appointment (MM/DD/YEAR)
*
Age
Selected Value:
18
of public what
City of residence
*
Email
*
Phone Number
*
No VOIP numbers, burner numbers. This must be your personal cell phone number.
Weight and Height
*
Penis Size
*
Preferred Contact Method
*
Email
Cell phone
Other
Please specify how you want me to contact you back. If you need me to message you back using a method other than Cell Phone or Email then please include that in your introduction paragraph.
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