Boston Escorts

Nikki's Screening Form

About You
Name:		(required)
Email:		(required)
Phone Number:		(required)
Best times to call you:		(required)
Do you accept SMS text messages?	Yes No
Age:	18-23 24-30 31-40 41-50 51-60 61-70 Over 71
Ethnicity:	Mixed Other White American Australian British Canadian Eastern European French Italian Russian Scottish Welsh Other Hispanic/Latino Cuban Mexican Puerto Rican Asian Chinese Hong Kong Indian Indonesian Japanese Korean Malaysian Filipino Taiwanese Thai Vietnamese Other Aboriginal Arabian Black Caribbean Hawaiian Persian South American
Occupation:		(required)
Company Name:		(required)
Education:	Completed High School Completed Technical/Community College Completed University/College Completed Masters Degree Completed PhD
Relationship Status:	Single Dating Engaged Married Divorced Separated Recently Broke Up
Your Photo:		(optional)
Appointment
Preferred dates/times of appointment:		(required)
Preferred locations of appointment:		(required)
Preferred length of appointment:		(required)
Are you a traveler to this area?	No Yes
Your Outcall Location:		(optional)
Your Likes/Dislikes:		(optional)
Wardrobe Requests:		(optional)
Other Special Requests:
Who referred you or how did you hear about me:		(required)
References
Names and contact info of providers you've seen before Message/review boards you post on and your username
Enter text on the right:	(Refresh the page if you can't read this)

In order to provide you with the best possible service as well as for Nikki's security, please fill out this short form. All information will be held with the strictest confidence. If you upload an image, you can cover your face for privacy by wearing a mask while you take the photo or using photo-editing software.

Are you worried I'll use your personal information? Remember, YOU found ME! I didn't come looking for your personal information. I'm looking to do business; I need your information only for my security.

For your security, your screening profile will be automatically deleted after 7 days. You and the service provider have the option of deleting the profile at any time before the 7 days.

Once you submit, your non-personal information will be encrypted and saved in your web browser so you don't have to fill out all the information for other service providers. However, for your security, your name, email and phone number will never be saved. If you do not wish for anything to be saved, clear your web browser's cache.