Apply To Serve Name (required) Pronouns Email (required) Phone Number (required) Can I text you? (required) YesNo Age (required) Where did you find Me? For marketing purposes City/state of residence (required) Which city are you requesting a booking in? (required) Desired booking date (required) Desired booking time (required) Desired booking length (required) Incall or outcall? (required) IncallOutcallEither one Do you have BDSM experience? (required) Only exposed to it by media, never experienced BDSM in real lifeOnly with partners, never with a Pro DommeSome experience with a Pro DommeLots of experience with a Pro DommeOther If other, please specify: How would you describe yourself? What are you hoping to explore more with Me? (check all that apply) AbdlAnal PlayBallbustingBody WorshipBondageBoot WorshipCaningCBTChastityCock WorshipConsensual BlackmailCorner TimeCorporal PunishmentCross-dressingCuckoldingDegradationDomestic ServiceEdgingElectrical PlayFace SittingFace SlappingFinancial DominationFloggingFoot WorshipForced BiForced FeminizationGolden ShowersHumiliationImpact PlayInterrogationLatex/RubberMedical PlayMind FuckMummificationNipple PlayObjectificationOrgasm ControlOTK SpankingPaddlingPeggingPet PlayPredicament BondagePublic HumiliationRole PlayRope BondageRuined OrgasmsSensory DeprivationServiceSissy TrainingSmotheringSoundingSpankingSpitStrap-onTease and DenialTicklingTramplingVerbal HumiliationWax PlayWhipping Please provide direct contact information for a reference that you have seen recently (any type of provider is fine). (required) Please provide direct contact information for a second reference that you have seen recently (any type of provider is fine). (required) Do you have any physical or psychological conditions I should be aware of? (required) ***LIST ALL ALLERGIES INCLUDING FOOD AND LATEX HERE*** What are your "soft" limits (things you might want to try but feel hesitant about)? What are your "hard" limits (things that you absolutely will not do)? (required) Can I leave marks? How would you rate your pain tolerance? 1 - None2 - Low3 - Moderate4 - High5 - Very High In an ideal session, how will you hope to feel? (required - check all that apply) AcceptedAfraidBelittledBewitchedComfortableCompliantControlledDegradedEmbarrassedEmpoweredEuphoricExaminedExposedFearfulHelplessHumiliatedInferiorIntimidatedMesmerizedMindlessNurturedObedientObjectifiedOtherOwnedOvertakenOverwhelmedPlayfulProtectedProudReverentSafeSillySmallUsefulVulnerable If other, please specify: Anything else that you would like Me to know? I agree that I have read the FAQ, and if I am providing alternative screening information I am prepared to do so. If my application is accepted, a NON-REFUNDABLE 20% deposit will be required to secure my session. (required) Yes, Mommy!Yes, Miss Betty.
