Slave Application Form

This document is required in order for Mistress L to assess your suitability to serve - please answer as openly and honestly as you can, with as much detail as possible. It will be treated in the strictest confidence and its contents will never be revealed to any third party. The more open you can be with me, the more enjoyment each of us will get out of our time together.

1. About you.





Are You able to receive Emails from Mistress L?


Are You able to receive phone communication, eg. text messages?

If you have a partner, is She/he aware of your visiting a Mistress? (important in considering the level of marks resulting from a session)
(discretion required regarding bodily markings etc).

Important health information. (This is required in order to ensure a safe session for you) Do you have or have you ever suffered from any health problems that may affect the session? This includes heart conditions, transmittable viruses, high blood pressure, etc.

Do you suffer from any allergies?

Have you recently been injured, or do you have any old injuries that re- occur?

Do you suffer from any phobias?

2. About your submissive nature.

Please indicate your degree of submissiveness

Please indicate your degree of experience as a submissive

How would you describe your attitude and tolerance to pain?

What level of bodily marks can you sustain?


Please consider the list below and express your level of experience in each and your interest in exploring them in session. Tick the relevant boxes according to these scales;
1. I have never experienced this
2. I have limited experience
3. I have reasonable experience
4. I am very experienced

Willingness to explore this area
A. I have no wish to explore this
B. I would unwillingly explore this if Mistress wishes
C. I am ambivalent / would not mind exploring this
D. I am keen to explore this area
E. I greatly desire the chance to explore this area

                                                                     Experience                                                                   Willingness to explore
24/7 (Total power exchange)                                                                   
Breath play                                                                                              
Blackmail (consensual)                                                                             
Blindfolds / hoods / masks                                                                        
Body hair (pulling)                                                                                    
Bondage (rope)                                                                                        
Bondage (tape)                                                                                         
Bondage (shackles / chains)                                                                      
Bondage (genital)                                                                                     
Bondage (body bags etc)                                                                         
Breast / nipple torture                                                                               
Candle wax                                                                                              
Collar & leash                                                                                           
Confinement / caging                                                                                 
Corporal punishment (crop)                                                                       
Corporal punishment (cane)                                                                       
Corporal punishment (other)                                                                              
Equestrian / pony play                                                                                
Financial slavery                                                                                         
Foot worship                                                                                              
Boot / shoe worship                                                                                     
WS (golden shower)                                                                                     
Handcuffs / shackles                                                                                      
Humiliation (verbal)                                                                                        
Human furniture                                                                                             
Interrogation scenarios                                                                                   
Kidnap scenarios                                                                                           
Maid training                                                                                                 
Needles / piercing                                                                                          
Puppy play                                                                                                     
Mild physical abuse (slapping)                                                                        
Extreme physical abuse (punching / kicking)                                                    
Role play scenarios                                                                                            
Sensory depravation                                                                                         
Slut training                                                                                                     
Torture scenarios                                                                                              
Trampling (boot / shoe)                                                                                    
Trampling (feet)                                                                                                 
TV transformation                                                                                                  



Would you be interested in posing for photos for Mistress?

3. Specific Fetishes (skip to section four unless you fall into one of these categories: TV, Financial slave, full time applicant)

TVs: Circle one or more
I feel my feminine persona is...

I hope that when I am feminised my Mistress finds me:


Money slaves: Circle one or more

I wish to...


Which statement do you most agree with?

Domestic applicants:  (Only fill in if you have been asked to)
What talents or skills can you offer me?



Are you happy to take on tasks other than the ones specified above?

Please note that full time slaves toil because they wish to please Mistress and should never expect to be granted a reward for the privilege of serving. However, I may wish to treat those who please me most with the occasional reward. Full time servants are generally picked from those who have been with me the longest.

4. About Your ideal Mistress.

Which of these qualities would you hope to find in Mistress?

Mistress attire

My usual wear during a session is a dress, heels and stockings, and perhaps a corset, as this is what I feel most comfortable in. However, I realise that some clients yearn to see me in particular clothing, and I MAY choose to indulge this.

How important is it for your enjoyment of the session to see me in particular clothing?


Please note that I do not allow release as a matter of course and that I will never personally relieve you. That said, please indicate how important release during a session is to you.