Book Me

To book an appointment to meet me, please fill in the form below.

mscharlotteharper@protonmail.com

(Be sure to check junk mail folder for replies)

    Your Details

    * Full Name:

    * Email:

    * Telephone Number:

    Appointment Details

    * Date of Booking:

    * Time of Booking:

    • :

    * Duration:

    * Incall/Outcall

    * Please provide your location name and address:

    * Please provide your location name and address including country & city:

    Screening Options
    (choose your preferred method of screening)

    Companion References
    Minimum of 2 references from companions you have visited in the last 6 months. Name, website, email + phone number.

    * Companion reference 1:

    * Companion reference 2:

    Employment Verification

    * Please provide a copy your work ID card(max file size 5mb):

    * Please provide a recent photo (max file size 5mb):

    ID

    * Please provide a copy your photo ID (max file size 5mb):

    * Please provide a recent photo (max file size 5mb):

    LinkedIn

    * LinkedIn profile url:

    * Please provide a recent photo (max file size 5mb):

    Additional Information

    * Where did you hear about me?

    * If other, please state below:

    * Please enter the directory name below:

    Would you like to share your picture with me? If yes, please upload. (max file size 5mb)

    Comments / questions / requests...