First-time patrons are required to complete this form in its entirety. Returning patrons and those who have undergone pre-screening are only required to submit their appointment request below.
To complete pre-screening, please contact us at appointments@courtxxi.com.
Name (required)
Email (required)
Resident City (required)
Telephone Number
Appointment Request
Court XXI is pleased to host appointments at our private suite. General patrons are welcome to enjoy this unparalleled comfort and discretion for a modest fee. These luxurious accommodations are complementary for members of The Rose Guild.
To schedule at our hosting location, please select “XXI Clubhouse” under "Location". We can otherwise arrange transportation to your preferred locale.
Companion ---Eloise HayekNatalia FelixIlana MooreAkira Saint JamesClara RicciEmma OlsenSerafina D'ArcoBlair Emery
Preferred Date
City
Time
Duration ---One Hour90 MinutesTwo HoursThree HoursFour HoursSix HoursEight Hours12 Hours24 Hours48 Hours72 Hours
Location ---XXI ClubhouseOther
Address if "Other" was specified
Screening Information
We require at least two (2) references from companions who can attest to your upstanding character and gentlemanly comportment. These references should come from companions with a verifiable online presence, i.e., website and/or social media, whom you have seen within the past year. Providing additional companion references can expedite the screening process.
If you do not have companion references, you are welcome to complete the screening process by submitting your information for identity and employment verification below.
Companion References
First Provider Second Provider
Identity & Employment Verification
Professional Website
Professional Email
Government Issued ID
