Enroll to Serve
Glad to see you wandering into My office for an appointment with Me. The first step to be graced by My command is by applying to be considered. Fill this form thoroughly, respectfully and thoughtfully for a higher chance of approval. To ensure safe end-to-end encryption between us, create a https://protonmail.com email account for your inquiries. I do not take same day appointments. See you soon ;)
Full Name
*
First Name
Last Name
Preferred Name/Scene Name
Pronouns
Age (21+ Only)
*
Phone Number
*
Please enter a valid phone number.
Email Address
*
example@example.com
Occupation
*
City, State you reside in?
*
What experience are you looking for?
*
Please Select
Classic BDSM Session - 90min+
Welcome to My office - 1hr Intro
Rope Submission 2hr+
Suspense & Surrender Package (4-5hr)
Sultry Dinner Date - 2hr+
How did you find Me?
*
Please Select
BlueSky
Ad Site
DickieVirgin
Other
If you selected "Other", specify below
Desired Session Date
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-
Month
-
Day
Year
What would your is your desired session date to see Me?
2+ Substitute Session Dates and Times:
*
In the event that your desired session date is unavailable, list two to three substitute date and times.
Desired Length of Time
*
Please Select
1hr - For Welcome to My Office ONLY
1.5 Hours
2 Hours
3 Hours
4+ Hours
Kink Menu (check all that apply)
Bondage (Rope/Shibari)
Body Worship
Foot Worship
Breath Play
CBT
Degradation
Human Furniture - Rope Bondage
Humiliation
Impact Play
Latex Fetish
Leather Fetish
Needle Play - MedFet
Mummification - Rope Bondage
OTK
Pegging
Predicament Rope Bondage
Pet Play
Roleplay/World-building
Sensation Play
Sensory Depravation
Sensory Overstimulation
Servitude Training
Slut Training
Smothering/Trampling
Sounding - MedFet
Tease + Denial
Tickle Torture
Other
If "Other" is checked, please describe:
What feelings would you like to experience with Me during session?
*
Eg: endurance, held, suffering, degraded, humiliated, cared for, challenged, fear, etc.
Are there any physical, mental, or emotional health concerns that I should be mindful of? Put N/A if 'Not Applicable'
*
You can be as to the point as you'd like (e.g. heart concerns, joints, etc).
What are your soft limits? What are your hard limits?
Experience with Pro-Domme providers?
*
Please Select
First time experience
I have seen Pro-Dommes from time to time
I regularly see Pro-Dommes
Provide names, email addresses and social profile of your previous providers that you've sessioned with in the last 6-10 months:
If you have no provided no reference above, choose a screening method:
*
Please Select
Photo of ID
LinkedIn URL or public social media URL
I provided previously seen providers above
Photo ID (you may block out your address)
Browse Files
Drag and drop files here
Choose a file
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LinkedIn or Social Media URL
Do you consent to photo/video clips during our session? (mainly posted on My BlueSky social media)
*
Yes, I consent to photos/videos
Yes, I consent but with no face
Yes, I consent but with no immediate visual identifiers (face & tattoos)
No, I do not consent to photo/videos
Anything else you wish to share about yourself?:
You have reached the end of your application. Now all you have to do is wait...
Final reminder: Ensure that you have filled out this form completely and thoughtfully. Incomplete forms will be rejected. Good luck ;)
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