Online Submission Application
BEFORE YOU FILL OUT THE APPLICATION: Make sure you've done your due diligence of me to ensure that I am the Domme you want to serve.

Upon reviewing your application, you will be emailed to set up a phone screening. So fill out this application as detailed & honest as possible.
Untitled Title
Name *
Your answer
Email Address *
Your answer
Phone Number *
Your answer
Age *
Your answer
City *
Your answer
Marital Status *
What are your online experiences? *
Be detailed & honest about what you ACTUALLY done.
Your answer
BDSM Interests & Boundaries/ Hard Limits? *
What is your fetish/kink? And play that you absolutely have no interest in participating in or experiencing. Be detailed & honest.
Your answer
If you have any references or questions, list them below.
Include Mistress Name w/ email OR phone number.
Your answer
How did you hear about If from a social site, what is the site & your profile/user name?
Word of Mouth, DDI, Eros, Twitter, Fetlife, CollarSpace, ETC..
Your answer
By checking this box, you understand that a $100 tribute is REQUIRED to book online time to serve me. *
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy