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Booking Request Form

'); document.write('Hello! This form is the most efficient way to book time with me. I also accept P411 and RS2K appointment requests.'); document.write(''); document.write('FIRST DATE REQUESTS: You only get one opportunity to complete this form with adaquate screening details. If you do not provide a last name or screening data i will require advance payment in full before proceeding. '); document.write(''); document.write('Please double check my rate by desired location and be sure you are familiar with my TERMS OF ENGAGEMENT which you are agreeing to when we confirm our plans. Submission of this form is not a promise or a confirmation. It is my goal-oriented way of simplifying the booking process - the first of many mutually beneficial exxxchanges. '); document.write(''); document.write('Click \"Submit Form\" complete the Captcha and click \"Submit\". This will trigger a \"Thank you\" landing page with a pix of me. If you do not get that page it may not have sent properly.'); document.write(''); document.write('Please give me as much notice as possible. I will always do whatever I can, but i am rarely available for short notice or even same day requests. '); document.write(''); document.write('You may email the info requested directly if you encounter any problems with the form, or do not wish to use it. '); document.write(''); document.write('danielle.lilly@gmail.com'); document.write('

I would like to book time with: *
Desired Time: *
Desired City: *
Desired Length of Encounter: *
Incall/Outcall Preference *
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