Mistress Listing Questionaire

COPYRIGHT 2008 MidwestMistress.com
No part of this form nor in its entirety may be duplicated, nor used as a basis nor concept for any Mistress or related web site or group whatsoever. MidwestMistress.com will pursue legal repercussions to the fullest extent of the law.

We will be providing the most extensive, equally presented, information of any Mistress Site. This site and this listing application has been carefully developed by Midwest Mistress and the web developer to offer easy to read information about a Mistress. This application will take approximately ten minutes or more to complete. There is no option to save and return to it, so it must be completed in whole.

It is HIGHLY SUGGESTED that you REVIEW THE ENTIRE questionnaire before you begin.

Your Private E-mail Address		THIS WILL NOT BE PUBLISHED
Your REAL FULL Name		THIS WILL NOT BE PUBLISHED
Your REAL Phone Number		THIS WILL NOT BE PUBLISHED

The following will be the basis for a Mistress Profile Web Page as defined in the Terms and Conditions for a one time set up fee of USD$25.00

Select color of Category Titles on the Associate Web Page:

	The listed Mistress Name plus title
	Your e-mail address to be published - check to be sure it is right
	What state should you be listed under
	What city is your studio or dungeon in
	What state/cities do you visit more than 20 days a year


	Your web site age verification entrance address - URL - www.
	Your 468x60 banner location to be added on your page - URL - www.
	Your picture to be added to this Associate Web Page - URL - www.
	The address of a group you want listed on you page as your favorite group

Natural or usual Hair Color		I wear wigs
Natural Eye color		I wear color contacts:
My Gender is		Transgender
Sexual Preference		Select your age Range
Do you have Aids/HIV		Do you switch
Do you have Hepatitis		I am in BDSM as
Other Transmittable/Herpes		I have been into BDSM	years

	The following are text fields. You are restricted to 100 characters including spaces.
BDSM affiliations & clubs
Awards to honorable mentions
I offer the following Seminars/Lectures
'Hands-on' Educational Classes
Published Books of Mine
Published articles about Me
Published interviews about Me
I offer telephone sessions
I have slave/sub who can join in
I do Double-Domina Sessions
I do Domina-Dom Sessions
Conditions of additional people:

	I offer the following Sessions for a tribute no less than USD per person
	½ hour	$.00
	1-2 hour	$.00 per hour
	3-5 hour	$.00 per hour
	6 hour plus	$.00 per hour
	Overnight	To be discussed with subject
	Week-end	To be discussed with subject
	Vacation: three or more days	To be discussed with subject

	Days of the week offered:
	Earliest Session start time:
	Latest Sessions start time:
	I accept same day sessions:
May consider labor for tribute:
Acceptance of charge cards:
Deposit required:

About Me personally

I am Matriarchal	I am a Gynarchist	I am a Feminist
Personally, I am VERY Sadistic	I can be Sensual Domme	I hate men
I am a Mistress but only BDSMers know it	I am a lifestyle Mistress - E/everyone knows	I am a Pro-Domme only
I can be intense but don’t have to be	I am an excellent disciplinarian	I will train for another Domme
I offer extended sub/slave Training sessions	I like submissive subjects	I like slave mentalities
I like a respectful challenge	I allow a slow word	I allow a safe word

I accept

Males	Females	Heterosexual subjects
Homosexual subjects	Bisexual subjects	Forced bisexual subjects
Trans/TV subjects	Novice	Over 21
Over 18	Over 40	Over 50
Over 30	Couples - 2 people	Watching guest (s)

Sessions can be/ are

At My personal dungeon	BDSM studio–industrial to office set up	During a convention/event
At a dungeon I rent/use	Located in a commercial area	Located in a residential area
At their home	At their hotel	At My hotel
I have full Bathroom Facilities	I have no running water - potty chair only	Take Me Shopping
Take Me to Dinner	Accompanying Me to BDSM Event	Take Me away on vacation

Animal Play

Horse & Show Ponies	Kitty Play	Piggy Play
Horse, buggy	Puppy Play

Candle/Oil

Candle/Wax Play – Mild	Candle/Wax Play –Medium	Candle/Wax Play - Heavy
Candle/Wax Play – Extreme - with burns	Hot Oil

Video / Pictures

I sell videos	I’ll take the pictures of you only in session	Cam recorded sessions offered
My photographer may be present @ session	I sell photos of Myself	Video of Myself

Role Playing

Boss	Interrogation/Prisoner	Teacher
Seductress	Nun	Nurse/Doctor
Girl next door seduces man	Grandma/Old age	Mother
Aunt	Witch	Goddess

Mothering/Corporal

Diapering	Diaper discipline	Spoon-feeding
Bottle-feeding	Force feeding	Soothing/holding
Time out in the corner	Corporal punishments	I give over the knee spankings
Paddles are for spanking	Bare hand spankings	Belts
Switches	Hairbrush	Mouth Soaping

Sensory

Over-stimulation	Complete Deprivation	Earplugs
Blind-folds	Deprivation tank	Hood – Spandex
Hood - Rubber	Hood - Latex	Hood – Leather
		Liquid Latex
Introduction to BDSM and Training

Dungeon Monitoring	Dominance Training	Gynarchical Trainging
BDSM Etiquette & Language Training	maid/servitude Training	slave Training for Another

Humiliation & Water Sports

Public Humiliation	Private Verbal Humiliation	Training to be human furniture
Kicking	Punching	Face slapping
Spitting	Used as Foot mat/ foot rest	Consensual "blackmail"
Potty chair	Scat	Human toilet paper
Golden shower – full	Golden shower – topical	Head dunked in toilet

Medical

Vaginal Exam Medical Table	Specula/Speculum - Internal exams	Shaving
Urethral Dilation / Sounds	Catheterization	Bladder Irrigations
Enemas	Infusion	Pin Hammer
Spiked Roller	Wartenberg	Percussion Hammer
Dental Exams	Dental Chair	Jennings Clamp
Retractors	Sutures	Suction Pump for nipple &/or Nipples
Straight jacket	Hospital Grade Alcohol & Soaps	Non-Latex gloves
		Autoclave
Genital to Anal Play

CBT – Light	CBT – Moderate	CBT – Heavy
CBT – Extreme	Penis Pumps/Suction	Clothespins
Parachute and weights/Stretchers	Genital Boards	Genital Crushing
Humbler	Genital Bondage	Genital Flogging
Kicking – Heel crushing	Anal Play	Strap on Training
Anal Fisting	Vaginal Fisting	Rubber dildos
Latex dildos	Jelly dildos	Plastic dildos
Inflatable dildos	Wands	Glass dildos
Finger gloves or mouth vibrator	I have/use insertable vibrators	I use vibrators externally only
Eggs	Sybian	Love Machine - Fucking Machine

Chastity

They must bring chastity device	I am a key holder – for free	I am a key holder – for a fee
I have My own devices	I use locks	I use tamper proof numbers

Electrical

Violet Wand	TENS Type - Electrical Play Topical	TENS Type - Electrical Play Internal

Gags

Funnel Gag	Open mouth ring gags	Spider gag
Gag balls	Dirty panties	Penis gags

Worship

Bare foot Worship	Worship to knee only	Leg Worship
Hand Worship	Arm Worship	Armpit Worship
Goddess Worship	Massage receiver	Manicure receiver
Pedicure receiver	Shoe Worship	Boot Black
Boot Worship	Ass Worship / Smothering	Face Sitting

Forced Fem & sissies

I take sissy subjects	I have fewer than five wigs	I have more than five wigs
I have make-up for sissies	I have sissy fake nails to apply	I have some sissy shoes
I have sissy lingerie and hosiery	I have sissy dresses and clothes	I may take the sissy out in public
I do ‘forced’ feminization	I want a maid as a session	I want a CD Tramp
Voice Training	Heel training, walking, sitting	Complete Transitional Training

Restraints to Mummification

Wrist Cuffs	Ankle cuffs to Thigh Cuffs	Metal - handcuffs
Locking Cuffs	I have a cage	I have a cell
Locking closet	Slip Ring tethers	Swings
Rope	Shibari	Chains
Arm sleeves	Bondage mitts	Leg sleeves
I do immobilization bondage	I do plastic wrap mummification	I do ace bandage mummification
Plaster mummification	I do rubber mummification	I do vinyl mummification
I do leather mummification	I have a vacuum bed	I have body bag

Nipple/Breast

NT Clamp/clip less 5	NT Clamp/clip + 5	Abrasion
Clothespins	Vibrating clamps	Breast Press

Smoke & Fire

Smoking Fetish	I always smoke in a session	Cigar smoker
Will not smoke in sessions	Human ashtray to stamp out my smoke	Human ashtray – ashes only
Cigarette burns	Fire Play	Temperature play

Tortures

Weights	Figging	Hot pepper torture
Foot Torture	Tickle torture	Tease/Denial
Situational Torture	Kidnapping Play	Blackmail Play

Money slaves

Postal mail only money slaves	Telephone money slaves	On-line Money slaves

Food

Food Play & Games	Vomit Play

Single & Dragon Tails

I am not skilled using tails	I have 5-10 different tails (dragon/single)	I have fewer than 5 tails (dragon/single)
I have over 15 different tails (dragon/single)	Buggy Whip (over 5’)	Trainer Whip (under 5’)

Spanking & Paddles

I have fewer than five different paddles	I have 5-10 different paddles	I have over 15 different paddles
I do hand spanking	I do over he knee spanking	Spanking bench

Floggers

I have fewer than 5 different leather floggers	I have 5-10 different leather floggers	I have over 15 different leather floggers
I have over 20 different leather floggers	I have plastic, beaded, or other	Floggers that can be bio cleaned
		Slappers
Caning & Rods

I do caning	I have fewer than five canes	I have more than five canes
I think caning should leave marks	I think caning should make you bleed	Disposable canes and rush
Disposable switches	Acrylic rods	Torture stick

Other Equipment

Vaginal / Anal Hook	I have a rack	Fantasy rack/inversion
Nose Hook	Torture box	Whipping post
I use an exam table	Ceiling Eyebolts	Cross or spread eagle
I have stocks	Wall Eyebolts	Cupping Set
CBT/ ‘V’ chair	Bats & crops	Unique implements

Edge Play

Vampire	Biting	Vampire/ bunny glove
Fingernail to claw scratching/digging	Trampling – genital and stomach/chest	Breath play
Needles	Knives / Swords

This is where you put a BRIEF narrative (something about yourself, additional toys/equipment, about what you do - etc.....)

You must agree to have an Associate Web Page. I have read and I agree with the terms and conditions . Yes

	Click Submit one time to apply your electronic signature and send This will be reviewed and You will be contacted at the private e-mail address given
	If you need to trash it and start over click this button

Return to Home Page

Midwest Mistresses - Pro Domme - Professional Domina - Dominatrix in the Mid West: Missouri, Illinois, Wisconsin, Kansas, Indiana, Iowa, Ohio, Michigan, Nebraska, Minnesota, North Dakota, South Dakota. What are your interests? Mistress, domina, madam, pro, domme, lady, dominatrix,spanking, BDSM, fetish, vinyl, pvc, leather, corset, BDSM, dress, Missouri, Illinois, Wisconsin, Kansas, Indiana, Iowa, Ohio, Michigan, Nebraska, Minnesota, North Dakota, South Dakota trampling, lesbian, Goddess, Grynarchal, Matriarchal, worship, shopping, personals, links, Bondage, Domination, Sadism, Masochism, submissive, transgender, education, sexual reassignment, Foot Fetish, Stocking, link, directory, gynarchy, forced fem, information, clothes, jewelry, leather corset, fetish shoes, Bondage, Domination, Dungeon rent, Sadism, Masochism, Rubber, Goddess, Enema, Medical, Role Playing, Electrical, Kinky, Dungeon Furniture, TENS, chastity, ball busting, golden showers, smothering, nipple torture, crushing, violet wand, needle, infusion, tease, denial, trampling, flog, whip, governess, OTK, paddling, spanking, power exchange, ball kicking, face sitting, blindfolds, sissy, sissy training, feminization, cross dressing, professional dominant, sex education, instruction, BDSM classes, slave, slave training, dominatrix, Gynarchic, Matriarch, foot worship, tickle torture, pony play, puppy play, kitty play, domination, female supremacy, sensual domination, medical play, animal play, dominance training, submission training, discipline, bdsm education, sm consulting, erotic, hypnosis, orgasm control, milking, fantasy, role play, force feeding, St louis, stl, missouri, MO, st. Louis, saint Louis Search our Mistresses to serve. submissive, slave, trampling, lesbian, strap-on, Goddess, worship, shopping, personals, links, Bondage,mistress, domina, dominatrix, spanking, BDSM, fetish, vinyl ,pvc ,leather, corset, BDSM, Goddess, worship, hopping, personals, links, Bondage, Domination, Sadism Masochism, submissive, Foot Fetish - or something not listed here?
Premier Professional Dominas in Missouri, Illinois, Wisconsin, Kansas, Indiana, Iowa, Ohio, Michigan, Nebraska, Minnesota, North Dakota, South Dakota.
© 2008 Midwest Mistress ~ Web Design by House of Sanctuary LLC