Note to applicant: your potential Master does not necessarily engage in any of the following-described conduct. However, it is essential that you provide scrupulously accurate answers so I can realistically assess your qualifications as well as whether I need to address other issues in your personality besides your desire to serve. When you have completed this form, email it along with a photo of yourself to SIR
YOUR EMAIL ADDRESS:___________________@___________________
DO NOT FORGET TO INCLUDE YOUR PHOTO WHEN RETURNING THIS COMPLETED FORM!!
For each item, you need to provide two answers:
For experience, write YES or NO next to each item to indicate if you have ever DONE that activity. For willingness, indicate for each item how you feel about DOING that activity by rating it on a scale of NO or 0 to 5. (“?" means you don't understand what the item is attempting to describe. NO means you will NOT do that item under any circumstances (a hard limit).
0 (zero) indicates you have utterly no desire to do that activity and don't like doing it (in fact, may loath it) and would ordinarily object to doing it, but you would permit the Master to do it if it they really wanted it. (sometimes called a "soft limit").
1 means you don't want to do or like to do this activity, but wouldn't object if it was asked of you.
2 means you are willing to do this activity, but it has no special appeal for you.
3 means you usually like doing this activity, at least on an irregular/occasional basis.
4 means you like doing this activity, and would like to experience it on a regular basis.
5 means the activity is a wild turn-on for you, and you would like it as often as possible.
Mark with an asterisk (*) those items which you are willing to do only with a regular and current sex partner(s), but not with casual play-partners. Note any additional information or nuances which might be important for your Master to know in the margin to the right. For example, under diapers you might wish to distinguish between "wetting" and "soiling".
Anal sex (bottom) :
If so, ever without condoms?:
Anal plugs (large) :
Anal plug (public, under clothes):
Animal roles :
Arm & leg sleeves (armbinders) :
Ass licking (giving):
Ass licking (receiving):
Bathroom use control :
Beating (soft) :
Beating (hard) :
Being bitten :
Breath control :
Boot worship :
Bondage (light) :
Bondage (heavy) :
Bondage (multi-day) :
Bondage (public, under clothing) :
Brown showers (scat) :
Cages (locked inside of) :
Cattle prod or stun gun (electrical toy) :
Cells/Closets (locked inside of) :
Chastity belts :
if you have had them used.. where?:
Do you swallow?:
Cock worship :
Collars (worn in private) :
Collars (worn in public) :
Cuffs (leather) :
Cuffs (metal) :
Diapers (wearing) :
Diapers (wetting) :
Diapers (soiling) :
Enemas (for cleansing) :
Enemas (retention/punishment) :
Enforced chastity :
Erotic dance (for audience) :
Examinations (physical) :
Exercise (forced/required) :
Eye contact restrictions :
Face slapping :
Fantasy rape :
Fear (being scared):
Fisting (anal) :
Flame play :
Foot worship :
Forced masturbation :
Forced nudity (private) :
Forced nudity (around others) :
Forced servitude :
Full head hoods :
Gang rape scenes:
Gags (cloth) :
Gags (inflatable) :
Gags (phallic) :
Gags (rubber) :
Gags (tape) :
Gas masks :
Given away to another Master (temp) :
Servicing another Master upon command:
Golden showers :
Hairbrush spankings :
Hair pulling :
Hand jobs (giving) :
Harnessing (leather and or rope) :
Homage with tongue (non-sexual) :
Hot Creams (Ben-Gay) on genitals:
Hot oils (on genitals) :
Hot waxing :
Housework (doing) :
Human puppy dog :
Ice cubes :
If you have experienced, where?
Leather clothing :
Leather restraints :
Licking (non-sexual) :
Lingerie (wearing) :
Manacles & Irons :
Massage (giving) :
Massage (receiving) :
Medical scenes :
Modeling for erotic photos :
Photographing your training sessions with your Master:
Mouth bits :
Nipple clamps :
Nipple rings (piercing):
Nipple play/"torture" :
Nipple weights :
Oral/anal play (rimming):
Over-the-knee spanking :
Orgasm denial :
Orgasm control :
Outdoor scenes :
Outdoor sex :
Pain (severe) :
Pain (mild) :
Piercing (temporary, play-pierce):
Piercing (permanent) :
Prison scenes :
Punishment Scene :
Restrictive rules on behavior :
Rubber/latex clothing :
Rope body harness :
Saran wrapping :
Sensory deprivation :
Serving as ashtray :
Serving as furniture :
Serving as a maid :
Serving as toilet (urine) :
Serving orally (sexual) :
Serving other Masters (supervised) :
Serving other Masters (unsupervised):
Servicing more than one Master at the same time:
Shaving (body hair) :
Shaving (head hair) :
Sleep deprivation :
Spandex clothing :
Speech restrictions (when, what) :
Spreader bars :
Straight jackets :
Strapping (full body beating) :
Suspension (upright) :
Suspension (inverted) :
Suspension (horizontal) :
Supplying new partners for Master :
Swallowing semen :
Swallowing urine: yours? others?
Swapping (with one other couple) :
TENS Unit (electrical toy) :
Vibrator on genitals :
Violet Wand (electrical toy) :
Voyeurism (watching others) :
Video (watching others) :
Video (recordings of you) :
Waxing (hair removal) :
Wooden paddles :
? Don't understand this item.
* I will do with current sex partner only.
NO I WILL NOT DO that item under ANY circumstances (a hard limit).
0 No desire, don't like, will permit if special to Dom (a soft limit).
1 Don't want to do, but will.
2 Willing to do, but has no special appeal.
3 Usually LIKE doing, on an irregular/ occasional basis.
4 LIKE doing, would like it on a regular basis.
5 WILD TURN-ON, would like it as often as possible.
What is YOUR favorite way to reach orgasm?:
What is YOUR favorite way to get your Master to reach orgasm?:
On a scale of 1 to 10 (10 being VERY strong), how do you rate:
a. Your sense of adventure:
b. Your willingness to try new things :
c. Your desire to take risks:
d. Your desire to be challenged by new people/places:
Date of Birth: _____/_____/_______ Age:_____ ATTACH A RECENT PICTURE
WITH YOUR APPLICATION
Race & Ethnicity:
Height: __________ ft _________inches
Are you currently shaved any place other than your face? Yes if so where?
What size dildo or butt plug do you use/or is most commonly used on you?
What you think is your best physical feature:
What you think is your worst physical feature:
Do you have any tattoos or piercing?
Do you smoke?
Do you drink?
Do you use drugs?
Have you been in a drug abuse program?
Ever been tested?
Date of last test:
Have you been diagnosed with mental problems?
Do you have any disabilities (visible or invisible)?
Do you wear contact lenses?
Do you have any special dietary needs or restrictions?
Are you allergic to dogs, cats, or other?:
Are you seeking true 24/7 ownership? (explain your expectations in detail)
How old were you when you first had your sexual experiences
Age with a male?
Age with a female?
When did you last have sex with a female?
When did you last have sex with a male?
Have you ever had a Master. live-in or weekend? If so describe the
Have you ever been unfaithful to your lover or Master?
Have you ever raised your hand to hit a friend, sex partner or lover?
Is there any reason why you would not be able to commit 100% as a slave?
(past present or future reason)?
What is the longest relationship you have been in?
What caused it to end?
How long ago did you last relationship end and why?
Have you ever exited a relationship without telling that person face to
If so why?
Have you ever intentionally made your sex partner or MASTER mad?
If so why:
Circumstances, frequency and preference:
What is the most ejaculations you have had in a 24 hour time period?
What are you looking for in a MASTER/submissive relationship?
Do you have a problem calling your MASTER "Sir" at al times?
When would you feel uncomfortable calling him "Sir"?
Is it important to you to have a MASTER who is well known or has an
important role in the leather community?
What would the MASTER'S (not the slave's) limits be in the administration
of corporal punishment?
Describe the MASTER of your dreams:
What has been your most intense scene involving SM/BD?
Have you ever been broken to tears in a scene?
Do you freely admit when you have done something wrong and are you prepared
for the punishment?
Describe: Have no problem accepting punishment and admitting wrongdoing?
Have you violated any law in the past two years?
Have you been arrested?
How do you characterize your housekeeping abilities?:
How willing are you maintain your Master’s living quarters? Are there any household chores you would prefer not to do?
Describe your culinary abilities:
Do you have any religious affiliation? If so, how important in your life are your religious beliefs?:
Describe your extended family. E.g., are your parents still alive, any siblings, and your level of involvement with them.
Do you have any strongly felt political beliefs? If so, describe.
When other people meet you and get to know you, what do you think is the MOST important thing about you that they like about you?
What is your worst habit, i.e., is there anything you do which you wish you could stop doing?
Overall, what do you think makes you the sort of person other people want to be around?
What personality trait of yours do you think your friends like the least?
Title and author of the last book you read:
Title of the last motion picture you saw:
What are your musical tastes?:
What is your current employment?:
Describe your hobbies:
Describe what social activities you regularly engage in:
What are your thoughts on obedience to a Master’s orders? Are there any situations in which you think you would hesitate to follow your Master’s orders?
In what areas would you not be willing to defer to your Master’s orders? Specifically, control of a slave involves control of his or her mind. Are there any portions of your thoughts which would be off limits to your Master. Explain.
One final question: Suppose your MASTER does something which strikes
you as being absolutely stupid, irresponsible, or asinine, i.e.,
something that makes you realize that your Master has flaws. How
do you believe you would handle this? How do you think it might affect
your ability to be submissive to your MASTER?