Centaur Media Model Application Form

All Information is 100% confidential and used only by our staff for approval purposes.
Name*

First NameLast Name
Stage Name
You can choose one later if you are unsure
Age*
Must be 18 years or older
Address*

Street Address

Street Address Line 2

CityState

Zip Code
Phone Number*

Area CodePhone Number
Email*
Gender Identity*
Sexual Orientation*
Position*
Dick Length*
inches
Height (ft)*
feet
Height (in)*
inches
Weight*
pounds
HIV Status*
Have you acted in porn before?*
If yes, what studios have you worked with?*
If no, write N/A
Interested In*

VideoSpecial EventsPhotographyEntertaining
Comfortable With*

SoloBarebackRoleplayToysAnalOralRimmingLeatherJocks & SpeedosWatersportsS&MB&D
Anything else we should know about you?
Include links to any social media too!
Face pic*

Browse Files

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Nude Frontal*

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Nude Rear*

Browse Files

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Dick pic*

Browse Files

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Extra pic

Browse Files

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Should be Empty: