Jordan Kingsley Reservation Form
Fill the form below and we will get back to you as soon as possible. All fields marked with * are required.
Full Name: *
E-mail Address: *
Date & Time of Appointment: *
City of Appointment: *
Name of Business or Employment: *
Work Number and Extension: *
Title or Position in Company: *
Cell Number: *
Home Number: *
Hair Color: *
Other distinguishable features:
Verification Services That You're A Member Of/Member IDs: *
References:Other Porn Stars/Famous Escorts You've Had Appointments With(if you booked thru agency put agency info): *
Comments, Questions, Special Requests?