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You must provide the following contact information:

Real Full Name

E-mail

(This is NOT listed anywhere only for TLCescorts records & it is Required to match PayPal Payment)

1. What type of site do you want?

Select Type of Listing Required: (Your own Name.com cost $20 extra per year for registration)

	YOUR OWN SUB-DOMAIN ACCOUNT
	yourname.tlcescorts.com $25 a month/billed quarterly @ $75
	http:// .tlcescorts.com

new name trans. name		YOUR OWN DOT.COM WEBSITE
		yourname.com (also available .net, .biz, &.info) $35 a month plus $250 Design Fee
		http://

2. How do you want clients to contact you: (you must provide at least an email address)

Webpage URL Address: (Your Current Webpage URL, if any)
*Cell, Phone or Pager#* (If you want clients to call or page you. )
*E-mail address:* How do you want Clients to contact you?
AOL, Netscape, ICQ OR MSN Messenger:

3. Please identify and describe yourself: (This is what the Clients will see in your PROFILE.)

Escort/Stage Name

City

State

Country

Please describe yourself...

Check the ones that Apply
Gay	Bisexual	Straight
Top	Bottom	Versatile
Cut	Uncut
Endowment

Age

Height

Weight

Body type

Body Hair

Hair Color

Eye Color

Available
Status

in	out	in/out

Hourly Rate	Overnight	Travel

4. Your Personal BIO/Statement (What clients will read about you in PROFILE.)

5. Additional Comments for TLCescorts Designers:

By submitting this listing to TLCescorts.com, you affirm that you: Are over the age of majority for the city/state in which you reside; and will hold TLCescorts harmless for any interaction you may have with people who have seen/found your listing on the TLCescorts Website.

After You Hit Submit Listing button the next page will show Our PayPal Link.
All listings are paid quarterly (i.e. $25 a month = $75 quarterly)
Failure to pay within 24hrs will result in your form possibly being deleted
and you will have to return to resubmit your listing.