Advertising Request Form

Services
Ad Request Forms

Individual Entertainer Ad Request Form

This Ad Request Form is meant for Independent Escorts, Massage Providers,
Exotic Dancers and any other Individual Entertainer.
If you are a business with staff, please use the Agency/Club/Parlour/etc. form.

Please allow 48 hours after you submit this form for your request to be processed.
Further details regarding ad information, photos and payment (if required) will be discussed at that time.

Please continue to the form below.....

** = Required fields - All other info is completely optional


Please allow 48 hours after you submit this form for your request to be processed.
A sample ad will be created and a link will be sent to you to proof read and approve.
Further details regarding ad information, photos and payment will be discussed at that time.
Ads must be prepaid before being added to Erotic Canada.


** = Required fields
All other info is completely optional
** Category:
** Affiliation:
Independent Agency Parlour Club Other
Business Name of Affiliate (if NOT Independent)
Location(s) you work in (or travel to)
** City and Province:
License # (if applicable):
(some locations in Canada require an escort to be licensed)
Contact Info
** Name:
(Name that will be displayed in ad)
** E-Mail Address:
(Required to verify ad copy before it's posted)
** Please Confirm
E-Mail:
(Re-Enter as above to ensure accuracy)
**
Display E-mail Address in ad? Yes No
Phone:
(Only if you wish a phone number to be displayed in ad)
Website URL http://:
(if applicable)
Personal Stats
Measurements:
Chest and cup size / waist / hips (in inches) - example 34B/24/34
Age:
You must be at least 18 to advertise here
Hair Colour:
Eye Colour:
Height:
(in feet/inches)
Weight:
(in pounds)
Services:
Incalls Outcalls Both
Clients:
Men Women Couples
Rates:
Availability:
Personal Greeting
to display in ad:




Photos
**Please choose one:
I will provide photos for my ad I prefer not to have a photo
Private messages to the Erotic Canada Administrator regarding this ad
Questions or Comments:



Referral info

If a current advertiser here referred you to this site please type the advertiser's name here:

Please allow 48 hours after you submit this form for your request to be processed.
A sample ad will be created and a link will be sent to you to proof read and approve.
Further details regarding ad information, photos and payment will be discussed at that time.
Ads must be prepaid before being added to Erotic Canada.
By submitting this request form, I swear that I am 18 years of age or older