Full Legal Name *

First Name

Last Name

Phone Number *

This should be your real phone number. I will never contact you here without permission. For screening purposes only.

(###)

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Screening Method *

Please choose at least one of the following 3 options. Please email me your screening materials when you complete this form. (ItsHarperLafleur@proton.me)

Photo ID, including your full legal name and date of birth

Company website where your name and photo is included, LinkedIn, or work badge with your name and photo

References from at least (2) two independent providers you've met with in the past year

Desired Date *

MM

DD

YYYY

Desired Time *

Hour

Minute

Second

AM PM

You have read and agree to my deposit and cancellation policy *

Yes

No

You read and agree to my "Etiquette/policies" page *

Yes

No