Name
*
First Name
Last Name
Age
*
Home City
*
Occupation
*
Please tell me about yourself.
*
Lifestyle, Interests, Hobbies, Causes that you champion/care about, Any pets?
Email
*
Phone
*
This is required, and must be your real, actual phone number - not an app or google voice. I will never contact you there without your express permission in advance.
Country
(###)
###
####
Your requested date
*
MM
DD
YYYY
Time
Hour
Minute
Second
AM
PM
Duration
*
Brief Introduction (2hr)
Drinks Date (3hr)
Dinner Date (4hr)
Tasting Menu (5hr)
Dinner and a Show (6hr)
Daylong Adventure (8hr)
Day to Evening Escapade (10hr)
Overnight / Slumber Party (16hr)
24hr Adventure
48hr Getaway
Travel (3+ days)
Message
*
City We'll Meet In
*
Preferred Location
*
Audrey hosts (private apartment or hotel)
Patron hosts (upscale hotel only)
Where will you host us? (if applicable)
What would you like our experience together to be like, in PG terms?
*
How would you like to feel during our time together? Afterward?
*
How did you hear about me?
*
What draws you to me, specifically?
*
Company Name & Website
*
Your LinkedIn page (with 500+ connections)
Professional Email Address (for screening only - I will never contact you there)
References (Names, emails, and websites of 2-3 independent companions that you've seen in the past year, if applicable)
Please confirm that you have read and understood my rates (https://www.meetaudreyquinn.com/patronage)
*
Yes, I've read and understand your rates.
No, I haven't reviewed your rates.
Please confirm that you have read and agree to my cancellation/rescheduling policy and my deposit policy (https://www.meetaudreyquinn.com/faqs)
*
Yes, I have read and agree to your cancellation/rescheduling policy and your deposit policy.
No, I do not agree to your cancellation/rescheduling policy and your deposit policy.
