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Thank you for showing interest. I do require my reservation form be filled out in its entirety. If however you choose not to fill out the form, you may email me the information.  The following information is only required for first time modeling assignments. Returning clients  may contact me via email. Thank you in advance. If you do not hear back from me within 24-48 hours of submitting a form, please EMAIL:  info@LuXurieLaRen.com                                                     

FULL LEGAL NAME *
FULL LEGAL NAME
Please do no use a nickname (e.g. "Tom" for Thomas)
PHONE NUMBER *
PHONE NUMBER
PREFERRED METHOD OF COMMUNICATION: *
Appointment Details
PREFERRED DATE *
PREFERRED DATE
Please understand that I have a career aside from this industry, which does mean that my availability has limits.
PREFERRED TIME *
PREFERRED TIME
Put 00 in for seconds
PREFERRED LOCATION: *Please be aware that Incalls may require a deposit in advance *
MODEL/COMPANION REFERENCES
Please provide the name, email, website address and contact number of at least two reputable models you have spent time with.
Online Screening Services
If you are a member of one or more of the following screening services, please provide the necessary details I need to verify you.
Acknowledgement
BY CHECKING THIS BOX YOU AGREE YOU HAVE REVIEWED THE RATES. *
PLEASE VERIFY THAT YOU UNDERSTAND THE FACT THAT I DO NOT SEE ANYONE WHO IS UNABLE TO PROVIDE REFERENCES *
BY CHECKING THIS BOX, YOU AGREE THAT YOU HAVE REVIEWED AND UNDERSTAND MY CANCELLATION POLICY.
BY CHECKING THIS BOX YOU UNDERSTAND THAT A 25% DEPOSIT IS REQUIRED TO SECURE YOUR BOOKING *
* This is a non-refundable deposit. Your deposit will be only be refunded if I cancel for any reason.
EMPLOYMENT VERIFICATION
I do offer an extremely discreet employment verification along with a Non Disclosure Agreement (NDA) as a courtesy.
1. A Business Card 2. Link to a Company Website 3. Company ID Badge