Application for butt surgery!

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Application For a Piece of Ass


City:______________________ State:_____________________ Age:__________ Phone:______________ SSN:_______________

Hair Color:__________ Real Hair Color:____________ Eye Color:___________

Dentures: __________ Weight: _________ Height:___________ Waist Size: __________ Breast or Bra Size: __________

Marital Status: Married___________ Single______________ Divorced:_________ Other__________

Are Your Breasts Real? ____________ Do You Like Them: Sucked_________ Chewed__________ Kissed____________ Caressed__________ Squeezed________ Licked_________ Other_____ All of the Above____________

Can You Stay Out Late? _____________ How Late?_____________ All Night? _________ Several Days? ___________

Do You Like To Have Sex And Be Screwed All Night? ____________

How Often? __________

Do You Like Oral Sex? _____________

Pussy Size: Small ________ Medium __________ Large ____________ Extra Large __________

While Screwing Do You: Faint______ Fart______ Cry______ Moan______ Hum______ Whistle______ Scream_______ Sing_______ Scratch___________ Just Lay There_________ All of the Above_____________________

List the Top 3 Positions You Like the Best: 1)______________ 2)______________ 3)______________

When You Cum Do You: Wiggle______ Wobble__________ Twist_______ Jerk_________ Scream________ Cry________ Just Start Humping Like Hell___________

What Kind of Screw Do You Like? Fast_________ Super Fast__________ Slow__________ All Night____________ All Speeds___________

How Many Times? _________________ How Long Do You Like To Screw At One Interval? ___________________________

If You Have Screwed Before, Give Two(2) References (Not Immediate Family)

Name:______________ Address:______________ Phone:__________

Name:______________ Address:______________ Phone:__________

Would your service be Free of Charge?_______

If Application Is Favorable, And If Not Free, What Are Your Charges For:

One Night_________ One Hour____________ Muff Burger Special or Blow Job?___________

What Credit Cards Will You Accept?

Master Card_____ VISA______ Am. Express_______ Sears________ JC Penney's___________ All of the Above________ Others_________

Comments __________________________

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CCOTL_Application for butt surgery!

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