Membership Application Form

** Apply Only If You Live In The Colorado Front Range **

All information must be provided so that we can determine your eligibility and assign you the most
appropriate volunteer.  This application and all related correspondence
with you will be held in strict confidence.
 

First Name:                              Last Name:    

Name is:              Real Name             Stage Name / Pseudonym 
Age On Last Birthday:                        
Height (ft/in):            Weight (pounds):     

Social Status:      Single              Significant Other (long-term)             Married
Primary Sexual Orientation:          Heterosexual            Bisexual           Lesbian

How Much Experience Do You Have Actively Working As An Escort?

   None                A Little (up a month or two)                More (3 months or more)
Are You Currently Actively Working As An Escort?
Yes                      No
If You're Not Currently Working As An Escort, How Soon Would You Like To Get Started?
(Enter something descriptive such as Immediately, As Soon As Possible, After Researching The Options, Next Month, etc.)

While escorting is commonly defined simply as receiving payment in exchange for one's time and companionship, as with any form of interpersonal relationship it can at times involve consensual sex.
How much sexual experience have you had?
 Limited             Some             Moderate:           Lots: 

Check All Areas In Which You Have Adult Industry Experience:
  None   Video Actress   Entertainer/Stripper
  Web Cam Model   Photo Model   Other

Sexually Transmitted Disease Status:  (Don't apply if you can't honestly check one of these buttons.)
I have not been recently tested but am low risk, have no symptoms, and believe I'm STD free.
 I've recently been tested for and found free of SOME STD's and believe I'm free of the others.
 I've recently been tested for and found free of all major STD's.

QUICKLY rate yourself on the following general personality traits.
(Don't over analyze yourself.  There are no right or wrong answers.  Your responses merely help us generally
determine which of our volunteers you'll best interact with.)

Example:  If you're very Shy, choose 1;  If average, choose 3;  If very Outgoing choose 5.

  1 2 3 4 5  
                                    Shy   Outgoing
           Sexually Passive   Sexually Aggressive
 Great Sense of Humor   No Sense of Humor
                     Easy Going   Demanding
           Happy-Go-Lucky   Serious
Enter and Verify the email Address You Want Us To Respond To.
This email address must be the same one we receive your photos from.
Your email Address:   
Verify email Address: 
How often do you usually check for email:
Every few days             Once a day           Multiple times a day
What is the best phone number to reach you at?
Phone Number:                     Cell Phone:    Land Line:
When is generally the best time of day to contact you by phone (check all that apply)?
Morning:           Afternoon:            Evening: 
How Do You Prefer to Communicate:            By Phone:              By Email:               Either: 

When are you generally available to get together?
(Check all the times that you are typically available most weeks.)

  Mon. Tue. Wed. Thu. Fri. Sat. Sun.
  --------- --------- --------- --------- --------- --------- ---------
Mornings:
Afternoons:
Evenings:
In general terms, where do you live?  
(Indicate city/town/area only.  No street address required.  Examples:  Aurora;  Loveland;  Near Boulder;  East of Ft. Collins. Your location can affect which volunteer we assign to you.)
Your Primary Current Occupation:  
(Enter something generally descriptive such as Student, Between Jobs, Retail Clerk, Office Worker,
Food Service, Medical/Health Services, Programmer, Sales, Education, Entertainment/Media, etc.)
In 2 to 4 sentences and in general terms, tell us something about yourself, your
education, interests, and hobbies, and why you're interested escorting.
Briefly describe the top questions or concerns that you currently have about escorting.
Your answers will give us a starting point for discussions.
 
 

Where did you learn about the Escorts Support Network?  (Select One)

Internet Ad Print ad
Search Engine Friend
Current member Other
 
By submitting this application you agree and certify that:
  • The application information provided here is true and accurate to the best of your knowledge.
  • You are a girl who is at least 17 years of age and currently resied in Colorado.
  • You do not intend to use any information obtained through association with the ESN to engage in any illegal activity.
  • You do not work for or volunteer for any law enforcement agency and do not intend to provide any such agency with information regarding the ESN or your association with the it.
  • You are currently involved in escorting or are seriously considering it and are interested in learning more about it.  You understand that in order to benefit from the ESN you will need to  spend time with your assigned volunteer and that we typically don't provide detailed information over the phone or internet.
  • Your association with the ESN will be entirely voluntary and will be done of your own free will with no coercion from anyone.

I agree with these statements.   (If you do not agree, do not submit this application.)
I do not agree.
 

 

Please review all your information to verify that it is correct and complete.

Then press the "Submit Your Application" button.
Press the "Clear" button to clear entries and start over.

                                                     

Click the Submit Button Only Once, Then Wait for the Confirmation Page.

Don't Forget To Email Your Photos

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