USA Reservations Form

Please fill out a reservation form below with the details of your request and one of our friendly staff will get back to you promptly

All USA meetings require screening - No exceptions

** Cancellations & date/time changes made within 24hrs of your confirmed meeting will incur a $100 re-booking fee on top of any future meeting **

*Represents Mandatory field(s).

Select country : *

First and Last name : *

Email : *

Contact Phone Number : *

Atlantic Members Username :

Resident city & State : *

Review site Handles (TER, Bigdoggie, 411, RSK etc) :

If you are not an Agency Atlantic Member you will need to provide the information in either Option 1 or Option 2

Option 1

Companion References :

References from 2 ladies or agencies who are well reviewed on C69 or TER - contact name, website, email & reviews link - references may take up to 48hrs to verify

Reference 1 :

Reference 2 :

Option 2

Employment Information
Please provide employment details below for screening purposes

Company Name:

Position/Title:

Company Web Site:

Main Company Phone Number:

Your Direct Line or Extension:

Do you have a cover story we should use when phoning you:?

Security code : *

(no SMS, whatsapp, LINE or Wechat)

USA Reservations Form

Option 1

Option 2

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