Applications will be accepted until March 31st, 2019.

Heartland Person of Leather Contestant Application Form

Please type or print your answers to the fo
llowings as complete as you can. Please e-mail a color or black/white photograph of yourself.


Full Legal Name (Confidential):

Mailing Address:

E-mail Address:

Phone Number:

Best Time to be reached:

(must be over 18)


Describe yourself:

In what clubs do you hold full or associate membership?

What offices or community service organization positions do you hold?

List current or previous Leather titles held:

What is your occupation?

What is your highest level of education?

College or University Attended?

Current Relationship Status:

Why do you want to become
Heartland Person of Leather?

What is/are your favorite fetish(s)?

What three words best describe you?


Please email completed form and picture to Master Patrice @