Application Form for Submissives

Application Form for Submissives

This form is for Face to Face sessions
For further questions, email Me at; Lady.Domina@iCloud.com
Name*

First Name
Email*

Confirmation Emailexample@example.com
Phone Number*
Please enter a number contactable on WhatsApp - If you're outside the UK, enter your area code.
Suggested date to discuss session details*

MonthDayYear
Date
Suggested session date*

MonthDayYear
Date
Do you understand that Miss Jazsmine's sessions do NOT include sexual activity?*

YESNO
Why are you interested in serving Miss Jazsmine?*
How much experience do you have as a Sub? Do you have any Dommes that can give you a reference?*
PROVIDE YOUR CURRENT OR PREVIOUS DOMMES SOCIAL MEDIA
What is your preferred type of Domination*

SadistSensualBrattyStrictHumiliating
What is your Pain level*
What are your Kinks/Fetishes?*

Ass WorshipBall BustingCBTChastity Contract/Erotic Sexual DenialCuckoldingDomestic ServitudeEdgingEncourage Bi-PlayFoot-WorshipFloggingGolden ShowersGood/Bad PainHuman FurniturePegging/Anal PlaySensory DeprivationSpankingSadismOther
Tools desired*

BlindfoldCaneChastity cageCollarFlash-light (Fake Vagina)FloggerLeashMouth-GagStrap-onWhipRopeFeminine Wear (Dresses, Heels, Make-Up)NONE
Physical Limitations? i.e bruising, markings etc*
Do you consent to images/videos during the session, if your Identity is concealed?*

YESNO
Should be Empty:

For further questions, email Me at; Lady.Domina@iCloud.com