Please thoroughly read through this page before filling out the form below.

Get in touch!

“Do you want to be a participant in life, or merely a spectator?” - Rene

Please complete the form below. If you prefer to send an email, please submit all of the information requested below to DCReneRose@gmail.com.

Name

First Name

Last Name

Subject

Screening Method (ID, References, Employment Verification, etc.)

Please include any information that can help confirm you are who you say you are. The more details the better! All information you provide is handled and disposed of discreetly. References may not be used as a sole screening method.

Deposit Method (PayPal Not Accepted at This Time)

Preferred Appt Date & Time

Please visit the page labeled "Travel Schedule" to confirm which dates will be spent in your city.

Date Length

My preference (and priority) is for appointments of three hours or longer! Attire requests are available for appointments of three hours or longer.

City & State

Meeting Location

My Place or Yours?

Where You Found Me

Standard or Upgraded Package?

Message

Tell me a little about yourself!

Rene Rose

Please thoroughly read through this page before filling out the form below.

Get in touch!

“Do you want to be a participant in life, or merely a spectator?” - Rene