I’ll Make your fantasy a reality Name * Full Legal Name First Name Last Name Email * Phone * Registered phone number listed in your name (###) ### #### What services are you interested in? * Dinner Date Only Skip to Dessert Fly Me To You Preferred Date * MM DD YYYY What is your budget? If you’d like a fully immersive experience as my surprise date please discuss prior your budget so I may have full discretion while planning our activities. The amount listed here is NOT included in my hourly rate. How did you hear about us? * Twitter Tryst Reddit Message * Please introduce yourself. All explicit forms of contact are filtered to trash bin. Time * Hour Minute Second AM PM Thank you! Talia will review your submission and follow up with you shortly! Have a lovely day!