Samantha Delucca

Book Me

To schedule your time with me please fill out my contact form or email me the inforrmation that is asked for on my form. I’m very well reviewed and ask that you provide references, employment info, or board IDs. If you are not willing to provide this, we will not be able to meet. Please allow time to check references.

sam.delucca@yahoo.com

Make an Appointment

YOUR INFORMATION

First Name *

Last Name *

Email *

Phone *

Age * (gentlemen over 35 preferred)

Ethnicity *

Text Message OK?

Yes No

Voicemail OK?

Yes No

Call OK?

Yes No

MEMBERSHIPS

Date Check

TER

P411

Other

REFERENCES

For those with no memberships: Two references are required (agencies and/or indy's) PLEASE READ BEFORE FILLING OUT: Please check with your references BEFORE providing them here and make sure that they are willing and available right away to verify you. They must be no more than 6 months old and still currently marketing themselves online.

Provider Reference #1

Name

Phone

Email

Website

Provider Reference #2

Name

Phone

Email

Website

EMPLOYMENT VERIFICATION

New Clients with no references or memberships, please provide

Employment Info

BOOKING DETAILS

Date *

Time *

Duration *

Location *

Have we meet before?

Yes No

Message

I understand what I'm doing

CANCELLATION POLICY:

I understand that things come up and at times cancellations need to be made, however, like any business, I do enforce a cancellation policy. It is simple, if a client cancels me within 2 hrs before the booking, he will be required to pay a $150 cancellation fee. (payable by credit card) - This fee will need to be paid before the client can book the next time.

Book Me

Make an Appointment

*CANCELLATION POLICY:*

Samantha Delucca Copyright © 2016 - document.write(new Date().getFullYear()). All Rights Reserved.

CANCELLATION POLICY:

Samantha Delucca Copyright © 2016 - . All Rights Reserved.