New Advertiser Form

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New Advertiser

"*"= This information is required
Sex *
Stage Name *
BASE City * (no state)
Advertising Market *
PUBLIC Number	(###) ###-#### or EMAIL FIRST
PRIVATE Number *	(###) ###-#### HnH Use ONLY

ENTERTAINMENT SERVICES "*"= This information is required
Categories *		Type *
		Agency


Special Category *	Additional Category for your ad to appear

My Donation	ex: 1st Hour example: $300
if left blank it will not	ex: 1.5 Hours example: $450
show in your profile	ex: Overnite example: $2,000

Couples *
Overnights *
Travel *
Incall *
Outcall *

DESCRIPTION INFORMATION "*"= This information is required
Age*
Height*
Body Style*
Body Size*	example: 36c-26-36 or 36D
Hair Color*
Eye Color*
Ethnicity*	ex: Caucasian, African American, Irish, etc...

INTERNET INFORMATION "*"= This information is required
Private E-mail*
Public E-mail
Website	http://

BIOGRAPHY

NO HTML PERMITTED...! IT SCREWS UP THE HNH PROFILES

"*"= This information is required

OPTIONAL DISCLAIMER

NO HTML PERMITTED...! IT SCREWS UP THE HNH PROFILES

ADVERTISING ACCOUNT SPECIFICS

"*"= This information is required

My "Secret Word" to identify myself to HeavenNHeels is:

I tour and/or travel, my AD will be placed in markets other than my local area.

HeavenNHeels may contact me via phone.

HeavenNHeels may contact me via email.

By checking the check box "Accept My Electronic Signature" and click the button labled I AGREE, I am submitting my electronic signature to represent that I agree to the following: 1. I have read, understand, agree to and accept all of the Terms and Conditions of this site. 2. I certify that I am eighteen (18) years or older, I own the legal rights and own the copyrights to all Materials I submit to HeavenNHeels.com 3. I hereby confirm that all individuals depicted in the Materials I submit to HeavenNheels.com were eighteen (18) years of age or older when the Materials were taken. 4. HeavenNheels.com has the right to use, alter, or display my stage name, biography, images, and other materials free of charge in connection with advertising or promoting HeavenNHeels.com 5. I am entering in to this agreement under my own free will. I am not under the influence of drugs, alcohol, duress or any pretenses.

ACCEPT MY ELECTRONIC SIGNATURE

To continue registration you must check the "check box"

YOUR IP ADDRESS OF "38.107.179.234" WILL BE NOTED IN YOUR ACCOUNT

Terms and Conditions


Terms and Conditions	"18 U.S.C. 2257 Exempt"	Copyright HeavenNHeels	Privacy Policy