Your name:
Your email:
Your city, state, or country:
Your phone number:
Your age:
Your current status:
1.
Single
2.
Divorced
2.
Married
3.
Long term relationship
Your occupation:
Your yearly income:
1.
Under $20K
2.
Bet $30-50K
2.
Bet $50-100K
3.
Over $100K
Part 1: General Information
Real time servitude experience:
1.
In fantasy only
2.
Novice
2.
Some experience
3.
Very experienced
Sexual orientation:
1.
Heterosexual
2.
Bicurious
3.
Bisexual
Are
you:
Describe your ideal relationship w/a Domme:
What services do you have to
offer me:
How often are you available to
serve me?
What sort of tone would you
like me to set in the relationship?:
Loving and supportive
Firm and no-nonsense
Seductive and playful
Just be yourself, Ma'am
Who have you served
before in real time?
Describe the fetishes you have,
if any.
Describe the experience
you have had with other Mistresses
concerning real life servitude.
Any other
comments?