1

Outside Man Application

Applicant Information

Full Name: Date:

Last First M.I.

Address:

Street Address Apartment/Unit #

City Country ZIP Code

Phone: Email

Date Available: Health record No.: Desired

Compensation:

Position Applied for : (Please check that apply from the following options)

Sex Surrogate - to provide sex on demand? YES

NO

Handyman i.e. doing odd jobs as needed? YES

NO

Sugar Daddy – to provide financial aid? YES

NO

Emotional companion with handholding? YES

NO

Special talent , explain:

References

Please list three professional references.

Full Name: Relationship Status

at the time?

Service Offered: Phone:

Address:

Disclaimer and Signature

I certify that my answers are true and complete to the best of my knowledge.

If this application leads to employment, I understand that false or misleading information in my application or interview may result in my release.

Signature: Date: