Confidential Questionnaire

(This questionnaire is only for students interested in pursuing the Blue Moon tradition.
It has been posted on this website for educational purposes.
You do not have to fill out this questionnaire unless you have been asked to do so.)

The purpose of this Questionnaire is to help us determine if Blue Moon Wicca and it's instructors can provide you with the information you are seeking. Completion of this Questionnaire does not guarantee acceptance for further study. If it is determined that we can not meet your needs we will, to the best of our ability, suggest other teachers or sources to assist you in your quest for knowledge. (Please use additional paper where necessary and attach it to this questionnaire) -- We wish to thank Rae Blackhood and the late Robin Blackhood for providing their questionnaire on which this one is based. Rev. 8/13/01; 5/26/03; 6/10/03; 6/27/03; 2/13/06).


1. Name (first name or magical name only is OK)

2. Phone:

3. Where did you find out about us?

4. Are you at least 18 years of age?

5. Do you live in St. Lucie County? If not, how far do you live from Port St. Lucie, FL?

6. How long have you been practicing the Craft?

7. What do you think worshiping Mother Earth is all about?

8. When is the last time you were in a Circle?

9. What Craft related books have you read?

10. When did you first find a goddess? When did you last worship her?

11. How do you feel about worship of and service to the old gods?

12. Which gods and goddesses have you studied and/or worked with?

13. Are you an initiate of any pagan, magical, esoteric or mystery school or group? If so please give names of groups and your level of experience in each group.

14. Do you belong to any other groups, societies or associations?

15. If you are in a committed relationship, how does your significant other feel about your interest in the Craft?

16. How do the other people in your household (parents, children, roommates) feel about your interest in the Craft?

17. How do you feel about alcohol?

18. How do you feel about drugs?

19. How do you feel about gay, lesbian, bisexual and transgendered persons?

20. Have you ever been convicted of a felony?

21. Have you ever been under psychiatric care?

22. What is your most memorable Craft, magical or Circle experience?

23. What is your most significant or moving psychic experience?

24. Do you have valid driver's license and reliable transportation?

25. Are you employed and/or a student?

26. How is your health?

27. Have you completed the Blue Moon Introduction to Traditional Wicca class? If so please give date of completion:


28. What do you think traditional Wicca is all about?

29. Have you ever worked with a traditional Coven? If so, which tradition?

30. Have you ever worked with a non-traditional coven or other Wiccan or pagan group?

31. Please provide a complete outline of your religious training and experience to date.


32. Why are you interested in becoming a member of the Blue Moon tradition?

33. What do you believe you can offer the Blue Moon tradition?

34. Do you have any questions about the Blue Moon Wicca Mystery School, Circle of the Moonlit Sea, the Classes or the instructors?

Those Blue Moon Wicca students who are going on to Outer Grove classes are asked to read the coven handbook, the Blue Moon Book of Light and sign the following statement. The handbook includes all the rules and regulations for the coven. It is called a book of light to differentiate it from a book of shadows which would be private coven information.

By my signature I acknowledge that I have read the entire Blue Moon Book of Light, reviewed it in-person with the HP and/or HPS, understand the concept of traditional Wicca, and agree with the rules set forth in the Blue Moon Book of Light.

I understand that to learn traditional Wicca requires an on-going commitment of time. At least one night per week will be required for either class, group ritual or private ritual in my own home. Daily meditation is highly recommended.

I further acknowledge that I believe in the Law of Three Fold Return and live by the Wiccan Rede.



Student's Signature / Date


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