Centaur Media Model Application Form

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

First Name Last 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

City State
Phone Number *

Area Code Phone 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 *

Video Special Events Photography Entertaining
Comfortable With *

Solo Bareback Roleplay Toys Anal Oral Rimming Leather Jocks & Speedos Watersports S&M B&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 *

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Dick pic *

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Extra pic

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Should be Empty:

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