Name: ___________________________________________
Age: ____
Phone: (____) ____________
Occupation: _______________________________________
Height______
Weight______
Married(Y/N) __
Single(Y/N)___
Other_____________________________________________
How often do you have sex?(check appropriate answer)
Daily __ Weekly __ Monthly __ As much as possible __
How long can u last (check appropriate answer)
1 min ___ 15 min __ 30 min __ 1 hr __ all nite ___
Do u like Giving oral sex (Y/N) ___
Which do u prefer (check appropriate box)
One on one__ Doubles __ Group ___
While having sex, what do u do (check all appropriate answers)
Faint __ Cry __ Moan __ Wiggle __
Jerk about __ Pant __ Sweat ___ Scream __
Hum __ Whistle __ Just lie there __
Go to sleep __ Watch tv __ Read __
Think of someone else __ Ball play__
List three positions u like:
1.
2.
3.
What is ur preferred pace (check appropriate answer)
Slow __
Fast__
Very fast __
Rigorous __
When is the best time to reach u (check appropriate answer)
Morning __
Afternoon __
Nite __
How late can u stay out (check appropriate answer)
11-12am __
1-2am __
all nite __
Any talent or skills(Y/N) if so, list:
Most interesting place you've done it:
What would you do to me if we were stuck alone together in an elevator for an hour?:
