Lord's Club is the world's most distinguished private club offering intimate celebrity introductions to affluent gentlemen seeking the finest quality companionship. Whether you are interested in an exclusive arrangement or an exquisite companion at your convenience, Lord's Club has just what you are looking for. You are successful and have everything you want in life, now it's time to enjoy it with the woman of your dreams!
Phone: (123) 456-7890
Email: info@lordsclub.com
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You'll have to create some text in here about the reservations system. Try to fill up as much space as possible to make the page balanced looking like this.

You'll have to create some text in here about the reservations system. Try to fill up as much space as possible to make the page balanced looking like this. You'll have to create some text in here about the reservations system. Try to fill up as much space as possible to make the page balanced looking like this.

PERSONAL INFORMATION
First Name:
Middle Initial:
Last Name:
Marital Status:
Date of Birth:
Occupation:
Company:
Address:
 
City:
State/Province:
Country/Region
 
CONTACT INFORMATION
Email Addresses
Home:
Work:
Telephone Numbers
Home:
Work:
Mobile:
Pager:
Other:
 
PAYMENT INFORMATION
We will require a 50% deposit upon confirmation of your reservation. Your deposit may be made by Visa, MasterCard or American Express.
This form is encrypted and secure.
 
Payment method:
Credit Card Number:
Expiration Date:
Security Code:
Billing Address:
Billing Telephone:
 
INTRODUCTION REQUEST

Which model would you like to
reserve an introduction with?
1st
Choice:
2nd
Choice:
3rd
Choice:
 
INTRODUCTION INFORMATION
Date(s) you would like to schedule an introduction:
Start Date:
End Date:
Type of introduction you are interested in:   Local:   -or-   Travel:
Other information that we should know about your introduction:
 
ADDITIONAL SERVICES
If you would like an all inclusive rate, please check the box for the services you would like us to include:
Roundtrip Airfare   Limousine Rental
Hotel Accommodations   Vacation Package
Other Service:
 
ADDITIONAL COMMENTS
Special instructions for the proper handling of your request:
Comments:
Terms:
I accept these terms:  
 
If the above information is complete and correct then click the button
below to submit your membership application now.