PHONES:

216.393.1976 Cleveland, OH

312.698.8784 Chicago, IL

646.827.4630 NYC, NY 

WEBSITES:

AdultCandyCane.com 

EmpressEnslaveme.com 

EMAILS:

Candy@adultcandycane.com

EE@empressenslaveme.com 

DominateGoddess@gmail.com

Below is my Session FORM.  Fill it out first, then you may contact me through phone or email as follow-up.  I will be responding asap.

I created all these web sites to answer your questions and made these forms for you to use.  DO NOT bypass them and contact me directly or I will not be happy.  My time is VERY VALUABLE and I don't appreciate it being wasted. Believe me, you don't want to piss me off!!!

Pay attention, follow directions and obey me completely!!!

SESSION FORM

Real Name*
Screen Name*
E-mail*
Occupation*
Employment*
Birthdate*	1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31   Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec   1940 1941 1942 1943 1944 1945 1946 1947 1948 1949 1950 1951 1952 1953 1954 1955 1956 1957 1958 1959 1960 1961 1962 1963 1964 1965 1966 1967 1968 1969 1970 1971 1972 1973 1974 1975 1976 1977 1978 1979 1980 1981 1982 1983 1984 1985 1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010
Contact Phone*
Height & Weight*
Can you send me a photo?*
Physical or medical restrictions:*
Session Date*	1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31   Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec   2010 2011 2012
Session Time*
Session Duration*
Session ADDRESS*
Directions*
How did you find me?*
Escort Referral*
Mistress Referral*
Any limits?*
Any restrictions?*
Comments or explanations:*
Screening	Service DateCheckRoomServicePreferredTheEroticReviewI don`t have Public User
Code*
* = Required field