Request Your Own eDivaMedia Web Site

ATTENTION MODELS

Are you interested in supplementing your income with a membership based web site?
Do you have the motivation but don’t have the programming skills or the time?
Don’t have thousands of dollars to invest in start up costs?

eDivaMedia.Com might be the solution for you.
We will design, maintain and host your Custom web site at no cost to you!
For more information on how to get your own eDivaMedia Sponsored web site,
please contact us by using the mail form below.
Production slots for cost free sites are limited. Only serious inquiries please.
*Note: On occasion our reply may get routed as spam on certain mail services.
Please be sure to check your spam folder for our response.

Your Name (required)

Your Email (required)

Subject

Stage Name

Model Type (required)
 Webcam Model Internet Model (no webcam)

Content you plan to provide. (Choose all that apply-required)
 Solo Couples (Male/Female) Girl/Girl Threesome+ Fetish Other

Do you plan to host regularly scheduled Live Chat with members? (required)
 Yes No

Quality of photos (Choose all that apply-required)
 Digital Webcam Professional

Video Quality (Choose all that apply-required)
 Webcam HD Webcam Camcorder HD Camcorder Digital Camera HD Digital Camera

Available Content: When will you be prepared to submit content for your site? (required)
 Immediately 1 month 2 months 3-6 Months

Your Photo (required)
Files no larger than 2.5mb in .jpg, .gif, .png or .bmp format only.

Photo 2 (required)

Photo 3 (required)

Photo 4 (optional)

photo 5 (optional)

Your Message

I certify that I am 18 years or older and the information that I am requesting and/or submitting may be adult related in nature and it is legal to do so from my current location.
I also certify that this request of service and submission of images has been performed on my own behalf and not by any other agent or proxy.
I acknowledge that eDivaMedia, in order to protect individuals depicted in images that are submitted via this form, potential eDivaMedia Models, eDivaMedia and its customers, withholds the right to *verify my identity prior to granting access to any eDiva issued accounts, information or servers.

Place the following text in the space provided

captcha

*About Model Verification