Halle Moore, Exotic Model

Phone: 612-643-1902
email:

Please fill out the form below to contact me.
This form needs to be filled out completely to make a reservation.

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Contact Info
*First and Last Name
*Your Email Address
*City of Residence
*Contact Phone	-
*Please specify your legal age
Employment Info - only needed if you don't have 3 or more well know provider references.
Company Name
Job Title
Work Phone	-
Appointment Info
Clothing Attire
Your choice of Lingerie
Incall / Outcall / Location
Requested Time on for hours
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This will be the only way to verify, please choose one	Preferred411 RoomService 2000 Work Verification
TER Handle and/or Membership #
2 Recent Provider References Required
*Reference #1 Name
*Reference #1 Email
*Reference #1 Phone	-

*Reference #2 Name
*Reference #2 Email
*Reference #2 Phone	-

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Reference #3 Email
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Contact Info