INQUIRY FORM

First Name

Last Name

Email Address

Contact Number

Preferred form of communication Preferred form of communication Email Phone (text only)

Employment

Website URL (if Any)

LinkedIn

Requested Engagement Requested Engagement The Interview (1 hr) *incall fee is additionalCoffee & Connection (1.5 hr)Networking Happy Hour (2 hr)Boardroom Meeting (3 hr)Mastermind (4 hr)Dinner Deep Dive (clockless and flexible evening)Long Haul Flight (14 hr Overnight)Out of Office (24 hr)Weekend Whimsy (3-Day)Fly Me to YouCustom Engagement

City

Date and Time of Meeting

Location Location Incall - I host the gentleman (*convenience fee applies when not on tour) Outcall - I visit the gentleman

How did you hear about me? How did you hear about me? Tryst Slixa Eros Other

Would you like to be added to my newsletter for candid photos and updates? Would you like to be added to my newsletter for candid photos and updates? Yes No