MASTER CLASS IN PROVOCATIVE MOVEMENT
Le Femme Le'Dusa
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Black Monroe' Gold Undertones
Any donation for "Beautyisarttoy" is greatly appreciated
Below is my screening form.
Please be sure to fill it out as thoroughly as possible, and send the documents as soon as possible (if any field does not apply to you, simply leave it blank)
I hope to meet with you very soon!
LE FEMME LE'DUSA
Dinner & Dancing 500
FOR THE SAFETY AND DISCRETION OF BOTH YOU AND I, PLEASE SUBMIT THE FOLLOWING INFORMATION/DOCUMENTATION;
ALL INFO IS CONFIDENTIAL AND WILL NOT BE SHARED WITH ANYONE! THIS IS FOR SECURITY AND VERIFICATION PURPOSES ONLY!
IF YOU ARE UNCOMFORTABLE WITH SUPPLYING SUCH INFORMATION, IT IS UNDERSTANDABLE, HOWEVER, YOU MUST UNDERSTAND THAT I, AS A PROVIDER, AM UNCOMFORTABLE ACCEPTING ANY BOOKINGS FROM NEW CLIENTS WHO CANNOT BE PROPERLY SCREENED AND VERIFIED.
***IF YOU FAIL TO PROVIDE SUFFICIENT INFORMATION BELOW TO IDENTIFY YOU AS A LEGITIMATE & SAFE HOBBYIST, YOU WILL RELUCTANTLY BE DECLINED, UNFORTUNATELY.
*A donation must be made to verify new subs
PERSONAL DETAILS (This information will be kept confidential):
* Full Name
(as printed on your Driver’s License)
* Home Address
(must match address on your Driver’s License)
* Home Phone Number
(your home phone will NEVER be contacted. This information is for verification purposes only)
* Work Address
(To verify your place of employment is legitimate)
* Work Phone Number
(& extension number, if applicable)
PLEASE SUBMIT THE FOLLOWING SCANNED DOCUMENTATION TO VERIFY
YOUR LEGITIMATE IDENTITY:
* Recent Photo
(jpg/png of head-shot is fine– this is to compare to the head shot on your Driver’s License)
* Scanned Copy of Driver License
(Do NOT cross off or blur out your License Number!)
* Scanned Copy of your Passport OR Birth Certificate
(or any other state or government issued documentation)
* Scanned Copy of RECENT Utility Bill
must have full name and address that match that on your Driver License- You may blur out or cross off any information not pertinent to identifying your full name, and residential address, i.e., any user names or passwords, Social Security number, etc.
Do NOT cross off your bill’s account number– this will be used to verify you are the owner of this account! It MUST show the date, your full name and your home address! NO exceptions)
* Scanned Copy of RECENT Work PayStub or Voided Check [for Direct Deposits]
must have full name and address that match that on your Driver License- You may blur out or cross off any information not pertinent to identifying your name, address and employer. i.e., Bank information, Social Security number, etc.- It MUST show the date, your employer’s corporate location headquarters and/or address, your employer’s
phone number, your full name and your home address! NO exceptions
Thank you in advance for your cooperation and understanding.
You will be contacted within 24 hours after I’ve received sufficient information to verify you.
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