Are You A Member Of LeFantasy Gold Membership Program?
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Your first choice of Companion:

Your second choice of Companion (in case 1st is booked):

City Rendevous (4h-24h)

Euro Weekend (48h-96h)

Erotic Escape

4 Hour

12 Hour

24 hour

48 hour

72 hour

1 week

Other

Your choice of City:

FIRST Preferred Start Date
SECOND Preferred Start Date
DAY
MO
YR
DAY
MO
YR

First Name
Last Name
eMail Address - Accuracy is Important!

NOTE: members do not have to fill out the remaining part of this section.
 Street
City
state/Province
country
PostCode

My Profession

Please contact me via: Telephone eMail
Phone Number Best (Local) Time to Call

Any Special Requests?

Our companions would like to know a little bit about the person they will be travelling to meet! It will be a big help in establishing a good rapport between you during the first meeting.
Age: ..... Height: ..... Weight: r..... Eye Color:
My Music Preferences are
My Cusine or Dining Preference
My Profession is
Favorite Sports
Favorite Hobbies
I consider myself
Outgoing..Reserved..Go with the flow!

Is there anything else you would like to add about yourself?

LeFantasy can arrange a hotel for you at a discounted rate. NOTE: We will need prepayment of number of nights stay to arrange your hotel discount. You will receive a hotel voucher from LeFantasy via fax. Check with Angela during the reservation process for details.If you are interested in LeFantasy making your hotel arrangements please select your hotel type preference so Angela can check availability and get back to you about it!

Three Star Hotel

Four Star Hotel

Five Star Hotel

No Thanks! I'll handle my own hotel!
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