In Office Individual Introductions Payment Form

Enter your destination city and desired date or dates for your introductions
(NOTE: This form is for Ukraine, Russian and other European personal introductions ONLY. For Asian and Latin American countries, please use our Asian/Latin Introductions Order Form HERE.)

City & Country(All):

Introduction Date(s):

Select how many women that you would like to meet in this city?

The introduction to each woman is $275.00 per woman. It is refundable or creditable if you don't meet for whatever reason.

1 Woman - $275

2 Women - $550 Total ($275 each)

3 Women - $825 Total

4 Women- $1,100 Total

5 Women - $1,375 Total

6 Women - $1,650 Total

• If, for any reason, you are unable to meet any of the women that you select, your money will be refunded or credited (optional) for that (those) women. We do not GUARANTEE that we can arrange a meeting with ANY of the women.

• It is unrealistic to expect to meet more than 3 or 4 women per day at the most. We must consider the women's availability and schedules. We will do our best to accommodate your schedule. Please keep this in mind when planning your trip schedule and try to be as flexible as possible.

Enter The Information For The Women That You Want To Meet
Please try to list the ladies of highest interest first.
If you don't have your complete list of ladies yet,
you can forward them later to our travel department.

Woman #1 Name:

ID Number:

#2 First Name:

ID Number:

#3 First Name:

ID Number:

#4 First Name:

ID Number:

#5 First Name:

ID Number:

#6 First Name:

ID Number:

Client Information

First Name:

Last Name:

Email Address:

Be sure to enter your account / login email.

Street Address:

City:

State:

Zip Code:

Country:

Phone:

Comments:

In Office Individual Introductions Payment FormUkraine | Russia | Europe Only

Client Information

In Office Individual Introductions Payment Form
Ukraine | Russia | Europe Only