Application Form
* = Required information
Your email address:
*
You MUST enter a valid email address above if you want a reply.
Your name:
*
Your age:
*
Your area of residence:
*
Gender:
Select the appropriate option here
Male
Female
*
Height range:
Select the appropriate option here
5ft and under
5ft 1in to 5ft 6in
5ft 7in to 6ft
6ft 1in and over
*
Weight range:
Select the appropiate option here
8st and under
8st 1lb to 10st
10st 1lb to 12st
12st 1lb to 14st
14st 1lb to 16st
16st 1lb to 18st
18st 1lb to 20st
20st 1lb and over
*
Any health issues:
*
Previous experiences:
*
Experience:
Select the appropiate option here
First timer - no previous experience
Novice - one or two sessions/some personal experience
Intermediate - I have had a few sessions/a fair bit of personal experience
Experienced - I have had lots of sessions/ a lot of personal experience
*
Fantasies or things you enjoy:
*
Dislikes:
*
Interests (select all those which apply):
Foot Worship
Shoe/Boot Worship
Trampling - bare foot
Trampling - with heels
Tie & Tease
Wax Play
Ice Play
Sensory Deprivation
Tickling
CP - Mild
CP - Intermediate
CP - Hard
Spanking
NT nipple play
CBT
Electrics
Ball Busting
Suspension
Bondage/restraint
Verbal Abuse
Dildo Play - Oral
Anal Play/Strap On
Forced fem/feminisation
Face slapping
Hair Pulling
Spitting
Messy Play
Forced Feeding
Animal Training
Collar & Lead
Role-play
Age Play
Domestic Servitude
Financial Servitude
Other
Please specify
How often are you available to play:
Select the appropiate option here
Weekly
A couple of times per month
Monthly
Every few months
As and when I can
*
If there is anything else you feel may be relevant to your application then add it here:
Now. Read through it, check all the information is correct & send it to Me.
***Be advised I no longer offer smoking and/or human ashtray as part of My sessions so do
not
ask for it.***
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