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Canada Nightlife Guide : Escort Sign-up form  
 

Escort Advertising Sign-up Form

Please fill out the following form to sign-up for Escort advertising on the CanadaAtNight.com web site. Provide as much detail as possible, as your potential clients are looking to find out as much detail about you. The more information and pictures that you provide, the more calls and inquiries you will get. Please note that we will contact you directly to confirm your information and your payment.

Personal Information
Name:
Email:


 
Show my email address
MSN Messenger:


 
Show my MSN messenger address
Phone:

Show this phone in my Ad
Phone (2nd Line):

Show this phone in my Ad
City:
  This information will be shown in the advertising. Please fill in all the required fields.
     
My Personal Profile
Description:
Photos:
(No Nudity)

Age: (in years)
Height:
Weight:
Shoe Size:
Waist Size:
Bust:
Bra Size:
Hip Size:
Dress Size:
Physique:
Skin Color:
Eye Color:
Hair Color:
 

Please take your time in this area. The more information you provide here, the more successful your ad will be.

An online store for toys and lingerie will be part of this directory. We encourage you to be honest with your shoe size, dress size, etc., so that clients can buy lingerie and toys for you, which MontrealAtNight.ca will anonymous and discretely ship to you.
     
Rates and Area
InCall area
OutCall Area
Rates
0.5 HR
1 HR
2 HR
3 HR
12 HR
24 HR
  Please indicate your rates and your area of coverage. It's important to let your clients know all the details before contacting you.
     
AD Categories you would like:
Escorts Independant Escort  Male  
Female Bachelor Parties Webcam / Web chat
Internet / Film Performer Main Stream Modeling Phone Sex
Music Video Dancer    
 

Select the ad categories you would like to be listed in. This will help us place you in our directory.

Plus indicate what job opportunities that you are willing to be contacted for, from people in the Music/Internet/Film industries.

Sales Associate ID:
 
Advertising Packages
Choose an advertising package (prices include GST):  

The only difference with standard and premium is that your ad will be place above the standard A-Z listings.

Automatically renew my account on a monthly basis

6 Month Standard Directory Listing ($265.00) - 1 month free

12 Month Standard Directory Listing ($530.00) - 2 months free

6 Month Premium Directory Listing ($397.50) - 1 month free

12 Month Premium Directory Listing ($795.00) - 2 months free

  
 
Payment Information * All of the following is required to process your order
How would you like to pay for your ad? Note that your ad will not be posted until payment is received.
Visa   Mastercard   Paypal    Cheque/Money Order    Western Union   
if you would rather call us with your payment information, dial 1-866-729-9653
 
If you are paying by credit card, fill out the following information:
Credit Card #

Name on Credit Card:

Billing Address

Expiry Date:

CVV2 Code:
(The last 3 or four numbers on the back of your card)
 
Form Security
* You must enter the correct code for the form to be submitted.
Code:
 
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