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IRP Application FormFirst Name____________________ Last__________________ Public Magickal Name________________________________________ Street Address________________ City________________ State_____ Telephone_______________________ Zip Code_____________ E-mail Address___________________ Website URL (if you would like one linked)_________________________ Can any staff member testify to your character? Yes_____ No_____ Note the WLPA staff member who knows you best: Laurie_____ Cheryl_____ Dylan _____ Joe _____ Saille _____ Rhonda_____ Chad _____ Audrey_____ Gavyn _____ Christina_____ Shelia_____ List three references (at least two of them business or organizational): 1)______________________________ Phone_________________ 2)______________________________ Phone_________________ 3)______________________________ Phone_________________ Astrological Information: Date of Birth______________ Place of Birth__________________ Time of Birth______________ AM_____ PM_____ Spiritual Information: Which of the following best describes your spiritual path? Witch _____ Pagan_____ Ceremonial Magician_____ Shaman_____ Druid _____ Other_____ If "other", please explain:____________________________________________________ __________________________________________________________ __________________________________________________________ How long have you been active in the Magickal Community? 1 year_____ 2 years_____ 3-5 years_____ 5-10 years_____ Over 10 years_____ Have you been initiated into a specific tradition? Yes_____ No_____ If yes, name that tradition:___________________________________ What degree do you hold in that tradition? First_____ Second_____ Third_____ Are you self dedicated? Yes_____ No_____ If yes, what guidelines do you follow? __________________________________________________________ __________________________________________________________ __________________________________________________________ __________________________________________________________ Name any covens, temples, or religious organizations that you belong to: __________________________________________________________ __________________________________________________________ __________________________________________________________ Are they legally recognized by the Federal/State government? Yes_____ No______ Describe the general practices and goals of your group(s): __________________________________________________________ __________________________________________________________ __________________________________________________________ How often does your group meet? Daily_____ Weekly_____ Monthly_____ Esbats/Sabbats_____ Sabbats_____ If you are self dedicated, how often do you perform rituals? Daily_____ Weekly_____ Monthly_____ Esbats/Sabbats_____ Sabbats_____ The Broom Closet: Do your friends and family know of your religious views and beliefs? Yes_____ No_____ How have they reacted? __________________________________________________________ __________________________________________________________ __________________________________________________________ If you feel that you cannot disclose your beliefs to your family and friends, why not? __________________________________________________________ __________________________________________________________ __________________________________________________________ Do your employer and co-workers know that you are a Witch? Yes_____ No_____ Have you ever been discriminated against personally because you are a Witch?
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