Rachelle Chase’s SEX LOUNGE Finding Derek CONTEST

To compete for the role of Derek Mitchell, hero of the SEX LOUNGE, please complete the following information. If you wish to protect your identity, your first and last initial can be made up, however, age, occupation, and hobbies must be true! This information will be displayed on FindingDerek.com.

* First Name

* Last Name Initial

Website (optional)

* Age

* Occupation

* Hobbies

* Have you ever helped a woman live out her fantasies?

* Tell us about it.

* ID Number = First Name + age

NOTE: You must state the ID Number above (Name+age) to identify yourself when you record your audio clip, otherwise we won't be able to match your entry to your audio clip! Please call 214-615-6044x2913 and record the following: "...he had no doubt what Nichole needed, what she wanted. He’d read it between the pages of a light-blue notebook. He’d felt it when he’d pressed her ass against the wall … and felt her tense in awareneness. He saw it now."

* Upload Photo 1

Upload Photo 2 (Optional)

Information requested below WILL NOT be displayed online. For legal reasons, I must collect your contact information. Additionally, it will only be shared with Rachelle Chase, sponsor(s), and/or celebrity judges of the SEX LOUNGE Finding Derek CONTEST.

* First Name

* Last Name

* Address Line 1

Address Line 2

* City

* State

* Country

* Postal Code

* Telephone Number

* Email Address

I certify

I am a male and 21 years of age or older. *

I certify

I am a legal citizen of the United States of America or legal permanent resident. *

Please read the SEX LOUNGE Finding Derek CONTEST Official Rules.

I acknowledge

I have read and fully understood "The Contest" "FAQs" and "The Rules for Derek" and agree to abide by the terms and conditions of the SEX LOUNGE Finding Derek CONTEST. *

You must certify the items above to participate in the contest.

* Verify (anti-spam protection code)

Have you recorded your audio clip of the SEX LOUNGE excerpt? If not, do not submit your entry yet. Entries must contain photo(s), completed entry form, and an audio clip. Incomplete entries will be deleted. Submissions will not be returned and become the property of the contest.

Thank you for entering the SEX LOUNGE Finding Derek CONTEST. Good luck!

Script by Dagon Design