application

 

 
Name you desire to be called

Real Name

Birth Date      

  E-mail address

State or Country where you currently reside

  When did you first realize your submissive nature? 

 What is the size of your manhood?

  With 10 being the highest and 1 the lowest, rate your pain tolerance?

The following are the most requested activities that I enjoy doing to my submissives. Rate these from 1 to 10 with 10 meaning you enjoy this activity the most. If you are interested in an activity that I do not have listed here, explain it to me in the fantasy question.

Spanking  

Nipple Torture

   Ice Torture
Verbal Humiliation   Cross Dressing   Verbal Abuse
Whipping    Face Slapping  

Hot Candle Wax
Foot Worship     Hair Pulling   CBT
Paddling    Being Bound   Chain or Rope Bondage
Crawling     Bound to a Table   Tens Unit or PES Unit
Caning   

Enema Play

   Milking
Led on a Leash    Sensory Depravation   Chastity
Tickling   Medical Play   Violet Wand

 Tell me about any limits you have. Criminal activities such as anything involving animals or children are out of the question.  I also do not do scat play.  Can you have marks?
 

If you have any medical problems, please list them here.  Are you taking any medications? Do you have any allergies?

 

Tell me anything else you think I should know.
  

Briefly tell me your fantasy  of what your session would be, how you are dressed, how I am dressed and what is taking place.

         

 

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