MISTRESS|SESSION|CONTACT|GALLERY|FAQ|APPLY|GIFTS|LINKAGE

This application is to be used for live session purposes ONLY.

Be sure to remove the check from any boxes that do not apply to you.

Incomplete forms will be deleted.

  

 

 

Full Name:  

  

Telephone Number:  

  

City, State & Country:  

  

your Email Address:  

  

Age: 18-25 26-35 36-4546-55 56-65 Over 65

  

Gender:Female Transvestite Transsexual Male

  

Sexuality:Straight Gay Lesbian Bisexual Undecided

  

Marital Status:Single MarriedLiving TogetherDivorced Separated

  

Use this space to include any personal information about yourself that you wish to 

convey to ME and was not mentioned above. (IE: date of birth, education, occupation, 

salary, payday, features, number of dependents living in your household, etc.):

  

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Calender Approved Date & Time Request :  

  

Level Of Service Experience: Virgin Novice Experienced Highly Experienced

  

Type Of Service Experience: None Distance Only Real Time Only Both

  

BDSM References (If any...):  

  

Describe in detail, what are your BDSM/ Fetish interests.

(If none, you may use this space to tastefully grovel.)

 

  

Describe in detail, what are your BDSM limits. 

(If none, you may use this space to tastefully grovel.)

  

Discretion is...    ... a must.  ... not an option.

 

Where did you find the link to MY website and what made you click that link?

  

Mistress, please contact me by: Email Telephone Both None

  

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On this day, i agree that all of the information above is accurate. 

i agree that all material collected about me, here and after, is the 

property of Mistress Fire Starter, to be used at Her leisure.

Yes, Mistress Fire Starter!

  

 

Signature: 

  

Date: 

 

 

  

 

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