If you are HIV+ and interested in performing in Adult Films, 
 please fill out and submit this application. 

Contact Information:
Name: First: Last:
Email: address@domain.com
Address: Street: City:
State: Zip: Country:
Birthday: Date of Birth: (MM/DD/YYYY) Age: Must Be 18 or Older!
/ /
Phone: Area Code + Phone Number Discretion Level

Physical Description:
Eye Color: Hair Color: Height: Weight:
Hair Style: Facial Hair Style: Race: Skin Color:
Chest Size: Waist Size:
Describe your body hair location and style: Describe any Tattoos and Piercings, including location and style:

Sexual Description:
Position: Erect Penis Size: inches or cm
 
What are you willing to do Sexually? Check all that apply:
Perform Bareback
Suck Dick
Get Sucked
Eat Cum
Rim
Get Rimmed
Kiss
Nipple Play
Water Sports
Leather
 
Describe any fetishes you have: Describe any special talents you have:
(Bondage, S&M, Foot or Shoe, etc.) (Self Suck, Double Penetration, etc.)

By placing a Capital X in this box, I understand that I am affixing this document with my Electronic Signature, and swear under the penalty of perjury that all information entered above is my own, and to the best of my knowledge true and correct. I further state that I am over the age of 18, or the legal age of consent in the area which I reside, whichever is greater. I also understand that this application is for HIV+ Models who will be working with other HIV+ Models, and state for the record that I am already HIV+ and am not using this company to spread HIV to myself or others.