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Sex Surrogate - Wish to Become One

Page One

Thank you for taking the time to fill this out.

I have no timeline as to when I will have the men who wish to hire a sex surrogate or the quality courses you can take, so please provide me with an e-mail address you will have for a while.

Thank you

Michelle

1. Your Contact Information

First Name *This question is required.

Last Name

Title

Company Name

Street Address

Apt/Suite/Office

City *This question is required.

State/Province *This question is required.

Postal Code

Country *This question is required.

Email Address *This question is required.

Phone Number

Fax Number

Mobile Phone

URL

2. Are you an existing Exotic Publishing client? *This question is required.

3. Which business kit or product did you purchase? *This question is required.

Please enter an 'other' value for this selection.

4. Have you worked as a sex surrogate before? *This question is required.

How long have you been working as a sex surrogate? *This question is required.

Years
Months
Weeks

Why did you decide to become a sex surrogate? *This question is required.

5. In your opinion, what is the difference between a sex surrogate & an escort? *This question is required.

Did you have training? *This question is required.

From where? (Please give the URL and city where you took the course) *This question is required.

Space Cell	URL	City
Course *This question is required	URL	City
Course 2 *This question is required	URL	City

What did you think of the course? *This question is required.

6. Comments