Submissive Application
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Government Name (for screening purposes)
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First Name
Last Name
Photo of you holding your ID
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Please ensure your ID shows at minimum your photo, full name, and the state. Everything else can be blacked out if you wish. This will be deleted immediately after screening.
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Scene Name (how you would like me to refer to you)
First Name
Last Name
Email address
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Phone Number
What is your occupation? (industry only is fine)
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Booking City
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Type of booking
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Session Domination
Domestic Servitude
Virtual Domination
Obedience App Management
Kinky GFE (pre-approval required)
Booking Date - Choice #1
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Month
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Day
Year
Date
Booking Date - Choice #2
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Month
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Day
Year
Date
Booking Date - Choice #3
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Month
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Day
Year
Date
Desired length of booking
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For domestic servants, how many hours are you able to commit? For Obedience app subs, how many weeks would you like to be managed?
Incall, Dungeon, or Outcall
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Incalls will be booked once your deposit is received. Dungeon fees are not included in my rates. For an outcall, just provide a ride share, and I’ll come to you.
Where did you find me? And what made you want to book a session?
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How would you like to feel during our session/s? What would you like to focus on?
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If you have any health, safety, or body related concerns please list them here
What kind of aftercare do you need?
If you’re seeking a long term connection or occasional travel companionship, share your monthly capacity below.
N/A if this does not apply
How many days a week do you envision service? And for how many hours?
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On a scale of 1-10, rate your satisfaction with your vanilla life.
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1= not satisfied, 10= very satisfied
On a scale of 1-10, rate your satisfaction with your social life (vanilla and/or kink).
1= not satisfied, 10= very satisfied
On a scale of 1-10, rate your level of body awareness.
1= not satisfied, 10= very satisfied
On a scale of 1-10, rate your level of emotional awareness.
1= not satisfied, 10= very satisfied
On a scale of 1-10, rate your level of comfort with rules and rituals.
1= not satisfied, 10= very satisfied
Type "I acknowledge" or "I agree".
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Signature
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