Application for Consideration

I respectfully apply for consideration to serve (Select Mistress) *

Role you wish to be considered for (Select Role) *

Name *

First

Last

Email *

Kink Name *

Contact Number *

Age *

Location (State/Country) *

Sex *

Sexual Orientation *

Height *

Weight *

Smoker/Non-Smoker *

Martial Status *

Profile Links (FetLife, Twitter, Website) *

Highest level of education *

Currently employed or retired? *

Convicted of crimes? *

Do you use drugs? *

Do you consume alcohol? *

Are you an extrovert (outgoing) or introvert (shy)? *

Do you generally have a positive outlook on life? *

Are you promiscuous? *

Do you have a valid driver's license? *

Do you possess a valid passport? *

New York, New York

Phone: (646) 893-8771

countessdionysusnyc@gmail.com