Application Form for Elysium

Name*

First Last

Professional Name (if applicable)

Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Personal Phone Number*

Professional Phone Number

Best phone number and time to call:*

Email*

Enter Email Confirm Email

Website

Date of Birth*

1. What bodywork classes/courses/workshops or certifications have you have taken?

2. Do you have any experience with professional bodywork?

3. Do you have any experience in private BDSM/Fetish play?

4. Have you worked as a Professional Dominant and/or Switched Professionally?

5. What is your style? Example: Mistress, Sensual Domme, Trainer, Bitch, Switch, Bondage Top, Sadist?

6. Please list any classes you have attended in BDSM?

7. Please list any books you may have read on BDSM?

8. Please list any educational videos you may have seen on BDSM?

9. Please tell us why you wish to work as a professional Elysium Practitioner:

10. Please list, in order of importance to you, what you wish to learn from your Professional Elysium Training Course.

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