Application for a Piece of Ass






Name    __________________________________________
Address __________________________________________
Phone   (______)__________________________________

Color of Hair ______________   Is it Real?  YES  NO

Do You Wear Dentures?  YES  NO

Marital Status: _____ Married
               _____ Single
               _____ Divorced
               _____ Other - Please Explain ____________________
                     ___________________________________________

Height __________  Weight __________ Waist Size ___________

Bra Size ____________  Hip Size _________

Are Breast Real?  YES  NO

Do You Like Them: _____ Sucked
                 _____ Chewed
                 _____ Kissed
                 _____ Squeezed

Can You Say Out Late?  YES  NO
   How Late? ________
   All Night?  YES  NO
   Several Days?  YES  NO

If Married, Can You Get Out During the Day?  YES  NO
   Breakfast?  YES  NO
   Noon?  YES  NO
   Afternoon?  YES  NO

Do You Like to be Screwed?  YES  NO
   How Often? _____

Do You Like Oral Sex?  YES  NO

Do You Give Head?  YES  NO

Do You Like Anal Sex?  YES  NO

When Screwing Do You: _____ Faint
                     _____ Fart
                     _____ Cry
                     _____ Scream
                     _____ Yodel
                     _____ Scratch
                     _____ Whistle
                     _____ Say "Oh, God"
                     _____ All of the Above

When Cumming do You:  _____ Wiggle
                     _____ Wobble
                     _____ Twist
                     _____ Jerk
                     _____ Scream
                     _____ Yell
                     _____ Just Start Humping Like Hell

How Many Times a Night do You Like It? ________
   Comments: _________________________________
             _________________________________

How Long Do You Like to Screw? _______

Do You Want to Screw Now?  YES  NO

If You have been Screwed Before, Please Give two References
(No Immediate Family)
1. __________________________
2. __________________________

If Your Application is Favorable, What are Your Charges? If Any;
   _______ Hour
   _______ Two Hours
   _______ All Night
   _______ A Quickie

Do You Like to do it:
   _____ In a Bed
   _____ In a Waterbed
   _____ On the Floor
   _____ In a Car
   _____ In a Movie
   _____ Standing Up
   _____ On a Slide
   _____ In a Whirlpool
   _____ In the Bathtub
   _____ In the Woods
   _____ On Top of a Building
   _____ Other, Explain:________________________________________