Application Form

APPLICATION FORM
(Please copy, paste into contact form and return to Mistress promptly for consideration)

Name and last initial______________________

Age______

Marital Status__________

Sexual Orientation__________________________

Medical Concerns/Physical Limitations _______________________________________________________________________

Phobias/Abuse Issues__________________________________________

Eyeglasses/Contacts?_______________

Pain tolerance (between 1 – 10, higher # = higher pain tolerance) ________
Can you be marked? _______
If so, for how long?_______________________

Which attire do you prefer to see your Mistress adorned in?
(Please choose all that apply and delete the rest).

Latex dresses/skirts
Leather
PVC/Vinyl dresses/skirts
Business attire
Corsets/waist cinchers
Fishnet
Sheer black
Nude pantyhose
Bare legs/none

Shoes
(please choose all that apply and delete the rest)
Knee-high boots/Thigh high boots
high heeled pumps (closed toe)
Peep-toe pumps or sandals (open toe)
Platform heels

In regards to Mistress’ demeanor during the session, I would prefer:
(please choose all that apply and delete the rest)

Indifferent/Detached/Cold
Playful/Gentle/Fun
Sadistic/Aggressive
Imperious/Condescending/Critical
Spoiled/Never satisfied

What best describes your reason for visiting Mistress?
(please choose all that apply and delete the rest)

Suffering to please Mistress and amuse Her___________________
Exorcism of guilt_____________
Sensation/Endorphin___________
Stress relief _______________
Other(please describe)_________________________

What would best describe the scenario you are seeking?
(please choose all that interest you and delete the rest)

Schoolteacher/naughty boy
Interrogator/prisoner
Female pimp/man-whore
Blackmailer/financial slave
Humiliatrix/small penis man
Mommy/Little boy
Other
(please describe) ________________________________________________________________________

How long have you been involved in BDSM activities?_________

Are you involved in any fetish/bdsm organizations? If so, which? _______________________________________________________

ACTIVITIES I AM INTERESTED IN:
(please choose all that apply and delete the rest)

1.Bondage: Leather, Rope, Bondage tape, Saran wrap
Method:  Light, Inescapable, Extended, Mummification

2.Pain (light/moderate) or Corporal Punishment: Flogging, Whipping, Strapping, Spanking, Caning, Hairbrush

3.Genital Torture/CBT: Whipping, Chastity, Stretching/Weights, tight bondage/tying, manual squeezing/vise, slapping

4.Worship: Stocking/Pantyhose, Shoe/Boot/Heel, Bare Feet

5.Humiliation Method: (please describe) ____________________________________

6.Puppy Training (yes or no): Caging, dog food eating, leash training, costuming, verbal command training

PLEASE READ!

I do not engage in any sexual acts (body worship included), smothering, infantilism, switching roles, piercing/cutting/burning, spitting, drugs, blood, scat, acts with animals or children.

Professional Domination is NOT prostitution, If you are looking for SEX, LEAVE NOW!

I require a minimum 24 hour notice for any session with a 2 hour emailed confirmation prior to our session.

All play is safe, sane and consensual. Also, safe words are utilized.

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