Individual's Ad Request Form


Individual Entertainer Ad Request Form

This Ad Request Form is meant for Escorts, Massage Providers,
Exotic Dancers and any other Individual Entertainer promoting themselves.

If you are a business with staff, please use the Agency/Club/Parlour/etc. form.

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.
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 (only if NOT Independent)
Location(s) you work in (or travel to) within Canada
** 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?
Yes Display in Ad No, e-mail is for Administrator's use only
Business Phone:
Only if you wish a phone number to be displayed in ad
Website URL http://:
(if applicable)
Services
In/Out:
Incalls Outcalls Both
Clients:
Men Women Couples
Fetishes:
Some Examples: Dom, Sub, Foot Worship, GS, Toys, Role-Playing
Rates:
Availability:
Days of the week, hours on call or "as per posted schedule"
Personal Stats
Measurements:
Chest & Cup size / Waist / Hips (in inches) - example 34B/24/34
Age:
You must be at least 18 to work in Adult Entertainment
Hair Colour:
Eye Colour:
Height:
in feet/inches
Weight:
in pounds (or an approximation *wink*)
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:



Please allow 48 hours after you submit this form for your request to be processed.
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