Submissive Application

Legal First Name *

Legal Last Name *

Age *

Relationship Status *0 / 50

Gender *

Sexual Orientation *0 / 50

Phone *

Email Address *

Confirm Email Address *

Preferred Method of Contact *SignalTextEmail

Signal Username *0 / 30

What is your experience level? *

Names you like to be called0 / 50

Kinks and fetishes you are into (Green) *BallbustingBlindfoldsBreath PlayChastityChokingCock and Ball Torture (CBT)Collar and LeashCropsCum Eating Instructions (CEI)DenialEdgingEye Contact RestrictionsFace SlappingFinancial DominationFloggingFoot WorshipGagsHair PullingHandcuffsHigh HeelsHuman AshtrayHuman FurnitureHumiliationIgnoreJerk Off Instructions (JOI)Key HoldingKneelingNipple ClampsPet PlayRestraintsSmall Penis Humiliation (SPH)SmokingSpankingSpitting

(cont.) Kinks and fetishes you are into and experience level (Green)

Soft limits (Yellow) *

Hard limits (Red) *

What kind of dynamic are you seeking? What are your needs & desires? *

What do you have to offer? Why should I consider you? How do you wish to serve? *

Do you have any medical conditions or allergies that I should be aware of? *

Can you be left with marks? *YesNo

Proof of Identity *Screening process is necessary to ensure you are of legal age. Please upload 2 files: 1 clear photo of your government ID, and 1 clear and unobscured selfie (without glasses/headgear) of you holding the same ID. Your torso and arms must be visible.

Drag and Drop (or) Choose Files

Employment Verification (e.g. Established LinkedIn Profile) *

Provider References or Social Media ProfilesIf you cannot provide employment verification, you must provide references. Enter details of 2 past providers seen recently: name, website, phone, email address. If you are new and have no references, you must provide 2 public profiles from 2 different social media platforms.

I understand that: *

The traffic lights system is used as safewords. GREEN: all good. YELLOW: reaching limit, slow down and check in. RED: stop immediately and end scene.

By clicking this button, I confirm that I am willingly submitting this form, and that I am of sound mind.

And by clicking this button, I agree to be loyal and devoted to Mistress Ren.