Name: Last First MI
Race: Phone: Social Security #:
Hair Color: Real?YesNo Eye Color: Dentures?YesNo
Height: Weight: Waist Size: Chest or Bra Size:
Marital Status: Married Single Divorced Other
Are Breast Or Balls Real? YesNo Do You Like Them: Sucked Chewed Kissed Carressed Squeezed Other None of the above
Can You Stay Out Late?YesNo How Late: All Night Several Days
Do You Like To Be Screwed?YesNo How Often: Do You Like Oral Sex:YesNo
Penis or Pussy Size: Small Medium Large Extra Large
While Screwing Do You: Faint Fart Cry Moan Hum Scream Laugh Whistle Yodel Scratch Just Lay There
When You Cum, Do You: Wiggle Wobble Twist Jerk Scream Cry Just Start Humping Like Hell
What Type Of Screw Do You Prefer? Fast Super Fast Slow All Night
How Many Times? Comments:
How Long Do You Screw At One Interval? Do You Want To Screw Now?YesNo
If You Have Screwed Before, Give Two References (Not Immediate Family): Name: Address: Phone:
Name: Address: Phone: If Application Is Favorable, What Are Your Charges, If Any, For: One Night: One Hour: Muff Burger Special: Oral Sex: What Credit Cards Will You Accept? Master Card Visa Sears American Express JcPenny's Marathon Shell Card Credit Card #: Expiration Date:
Signature: Date:
Submitted By: Anonymous