APPLICATION FORM
Please copy and paste into an email and return to Me, Mistress Kiva promptly for consideration.
My email address is: mistresskiva@gmail.com
Date/Time/Duration you are requesting an audience with your Mistress ___________________________________
Name and last initial______________________
Location___________________________________
Age______
Physical Description_________________________________________________________________________________________________________________
Marital Status__________
Financial Status and Employment Industry________________________________
Sexual Orientation__________________________
Medical Concerns/Physical Limitations_________________________________________________________________________________________________________________
Phobias/Abuse Issues__________________________________________
Eyeglasses/Contacts?_______________
Can you be marked? If so, for how long?_______________________
How often do you wish to visit with Me, (Mistress Kiva) Weekly? Bi-Weekly? Monthly? Bi-annually?_________________________________
Which attire do you prefer to see Me,(Mistress Kiva) adorned in? (Please choose all that apply and delete the rest).
Latex dresses/skirts
Patent Leather
PVC/Vinyl pants/dresses/skirts
Business attire/suits
English riding apparel/boots
Corsets/waist cinches
Catsuits
Hosiery (please choose all that apply and delete the rest)
Cuban heel/seamed
Fishnet
Sheer black
Nude pantyhose
Black Knee-high
Bare legs/none
Shoes (please choose all that apply and delete the rest)
Thigh-high boots
Knee-high boots
High-heeled pumps (closed toe)
Peep-toe pumps or sandals (open toe)
Platform heels
Mules
Goth boots
Goth Platform shoes
Gloves (please choose all that apply and delete the rest)
Latex (opera length)
Leather (wrist length)
Satin (opera length)
Bare arms/none
In regard to My demeanor during the session, (i the submissive, would prefer:) (please choose all that apply and delete the rest)
Indifferent/Detached/Cold
Playful/Gentle/Fun
Sadistic/Aggressive
Imperious/Condescending/Critical
Spoiled/Never satisfied
What best describes your reason for visiting Me? (please choose all that apply and delete the rest)
Suffering to please your Mistress and amuse Her (with disregard to my desires)___________________
Exorcism of guilt_____________
Sensation/Endorphin___________
Other(please describe)_________________________
What would best describe the scenario you are seeking? (please choose all that interest you and delete the rest)
Schoolteacher/naughty boy
Interrogator/prisoner
Female pimp/man-whore
Riding Mistress/ponyboy
Blackmailer/financial slave
Humiliatrix/small penis man
Mommy/Little boy
Other (please describe)____________________________________________________________________________________________________________________________
How long have you been involved in BDSM activities?_________
Do you have any other skills outside slavery that you can offer Me? How will you please your Mistress other than Her required tribute? __________________________________________
Do you have references from other Dommes (local,national or international)?__________________
Are you involved in any fetish/BDSM organizations? If so, which?_______________________________________________________
ACTIVITIES I AM INTERESTED IN: (please choose all that apply and delete the rest)
1.Bondage: Leather, Rope, Bondage tape, Saran wrap
Method: Light, Inescapable, Extended, Mummification
2.Corporal Punishment: Flogging, Whipping, Strapping, Spanking, Caning, Birching, Hairbrush
3.Genital Torture: Whipping, Chastity, Kicking/Kneeing,Trampling, Stretching/Weights, Chastity, Light touch cigarette, Hot wax, tight bondage/tying, manual squeezing/vise, slapping
4. Foot Worship: Stocking/Pantyhose, Shoe/Boot/Heel, Bare Feet
Method: Bootlicker, Toe Kisser, Masseuse, Footstool, Rug
5.Humiliation
Method: (please describe)____________________________________
6.Domestic Service Training (must be available with 2-8 hours notice): Chambermaid, Chauffeur, Foot slave, Dungeon Slut (forced-bi fantasy)
7.Shaving (yes, no or choose): Genital area, Body_____________
8.Smoking Fetish (Mistress smokes. Yes or No): Human Ashtray Service______________
9.Puppy Training (yes or no): Caging, dog food eating, leash training, costuming, verbal command training
10.Pony Training (yes or no): Show pony, cart pony, riding pony
11.Financial slave/Paypig/Blackmail (yes or no)___________
12.Cuckolding/Key-Holding CB-3000/6000/The Curve Long or short duration training
I love to entertain My guests. Are you comfortable being in a session/scene/show/party, with others:
Dominant Females
Dominant males
Submissive Females
Submissive males
Photographers/Videographers
Confidentiality is of supreme importance to Mistress Kiva. I may use Masks to hide your identity.