Employment Employment First Name * Last Name * Phone Number * Your Email * Address * Address Address 1 Address 1 Address 2 Address 2 City City State/Province Alabama Alaska Arkansas Arizona California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming State/Province Zip/Postal Zip/Postal Distance That You Will Travel * Under 1 Hour 1 Hour to 2 Hours 2 Hours - 3 Hours 3 + Hours Experience * No Experience Under 1 Year 1-2 Years 2-3 Years 3-4 Years 4-5 Years 5 + Years Have You Danced For House/Private Parties? (IE Bachelor, Bachelorette or Birthday) * Yes No Gender * Male Female Age * Ethnicity * African-American Caucasian Hispanic Height * 4'11 5'0" 5'1 5'2 5'3 5'4 5'5 5'6 5'7 5'8 5'9 5'10 5'11 6'0 6'1 6'2 6'3 Other Height If you were referred to us by another dancer please input their email here I Agree to Allow 123 Strippers to use my pictures on their webite * YES NO What Stage Name do you want with your picture? * Comments * Tell us why you would be good fit for our company, you can also leave references Facebook If you are using Facebook, please provide your profile link Instagram If you are using Instagram, please provide your profile link Upload Picture * Drop a file here or click to upload Choose File Maximum upload size: 67.11MB Upload Picture * Drop a file here or click to upload Choose File Maximum upload size: 67.11MB Upload Driver's License or other Form of ID * Drop a file here or click to upload Choose File Maximum upload size: 67.11MB