Pleasure Servant Application Form
You are required to complete the application form AND submit the application consideration fee with it. A paid application consideration fee does not guarantee approval. The fee is for the time of review.
Name
*
Name
Sub Name
Email
*
example@example.com
Name your social media
Birthdate
*
Location/Time Zone (State/Country)
*
Sex & Gender
*
Sexual Orientation
Relationship status/dynamic
Number of children, if any
If you are in a relationship/family, describe it
Level of education
Occupation/current job
Religion/ Culture
Have you been convicted of crimes?
*
Yes
No
If yes, list the the crimes
Are you an extrovert (outgoing) or introvert (shy)?
How sexually active are you?
How do you feel about yourself and your life?
Describe yourself and your personality to me
Explain your perspective and opinion towards Women/the Divine Feminine
Do you drink alcohol? How much?
Do you smoke? How much?
Do you exercise? How often?
Do you currently take drugs? If so, explain more. Also add previous drug consumption.
Do you have medical conditions or concerns?
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Yes
No
If yes, explain your medical conditions or concerns here:
Explain your current and past sexual health, including STI/STD:
Have you ever been diagnosed with depression, schizophrenia, bi polar, psychosis, anxiety disorder or neurosis?
*
Yes
No
If so, explain your treatment:
Explain your physical limitations here, if any:
Add your prescribed medications:
Add your allergies, phobias, triggers, abuse, PTSD or other relevant issues I need to be aware of:
*
How do you identify within D/s? (Eg. sub, slave, bottom, Little, Sissy, Pig, Toy, ...)
Explain if and how long have you been active within Kink/BDSM and describe your experience
Add any events or workshops you have attended
Add any BDSM organisations or clubs you are a part of
Add any books or other resources you have used for BDSM research
Add any pleasure toys and kinky tools you have
Provide your previous Domme contact details that I can contact for reference
Explain why you want to serve Me or get trained by Me
*
Explain how you desire to serve Me
*
Explain what are you seeking from serving the Queen or from getting trained by the Queen
*
Explain/List your needs, desires & goals
*
Explain/List your kinks and fetishes
*
Explain/List your limits and boundaries
*
Explain what actions are funishments or punishments for you (funishment = play you enjoy, punishment = play you do not enjoy)
Explain what kind of aftercare you require
*
Explain your commitments that will impact your ability to serve the Queen now and in the future
*
For financial Domination, explain your proposed pay schedule, amount & budget. Add if you desire attention or to be ignored when paying the Queen.
Are you able to download the Obedience App and get the premium version? (You can use my Code PLEASURETOYQUEEN to save)
Yes
No
Do you give the Queen Patricia permission to use any photos/videos from your sessions/programs with Her for Her website, social media, or other promotional purposes?
Yes
No
Are you ready to go beyond and above to serve the Queen?
Yes
No
Do you consent that you are acting on your own free will and are not being coerced into applying for consensual Female and/or Financial Domination consideration with the Queen and those associated with Her?
*
Yes
Do you understand that this application is subject to approval?
*
Yes
You agree to be of legal adult age to participate
*
Yes
You have read, understood and agree to the Terms and conditions as listed on pleasuretoyqueen.com
*
Yes
Do you confirm that you have answered all questions truthfully?
*
Yes
How did you pay the application fee?
*
List where you found/discovered the Queen first?
Add any other relvant information that the Queen needs to know:
Apply
Should be Empty: