1
IMBOLC
Walk your own Path into Western Magic
College Headquarter: D-87474 Buchenberg, OT Kreuzthal, Wirthsbergweg 13, GER
Questionnaire
for Prospective Participants in Distance Learning
of Hermetic Arts & Western Magic in Theory & Practice
Black fields = required
Grey fields = voluntary
MANDATORY DETAILS:
Desired Start of the Distance Learning Course: 1st _______ , __________ . Desired Study Module (A-D) ______.
Surname: _______________________________________ First Name/s: ________________________________________
Desired Alias/Pseudonym/Motto at IMBOLC: _____________________________________________ Still undecided
Date of Birth: ______. ______. __________. Age: ______ Zip-Code/Birthplace: ________-__________________________
Zodiac Sign: ______________________________________ Ascendant: __________________________________________
Domicile (Country/Postal Code/Town): _____________________-___________-_______________________________________
Street/No.: _________________________________-_______ Phone _____________ - __________________________
Email: ______________________@______________________ Internet: http:/__________________________________
Highest school degree: ________________________________ Nationality: _____________________________________
If you are/have been a Student: Secondary School Junior High Comprehensive School High School Class: _____
Polytechnic University Semester: ____ Main Study-Subject: _____________________________________________
Profession/s: ______________________________________________________________________________________________
Freelance Trader Employee Unemployed Sabbatical (or similar) Retired _____________________
Learned Profession: _________________________________________________________________________________________
Do you hold a political office or are you a member of a political party? Yes No Name: __________________________
Are you an active or passive member of an association or organization? Yes No Name: __________________________
Are you an active or passive member of a lodge or an order? Yes No Name: __________________________
Academic Degrees/Titles & Doctorates:
State Exam. Masters Exam. Diploma Bachelor Master Doctor Professor ____________________
2
Language Skills: (Please underline your native language/s)
German English French Spanish Italian Hindi Russian
Polish Japanese Mandarin Turkish Portuguese Arabic Greek
Other Language/s: ________________________________________________________________________________________
Intermediate Latinum Advanced Latin Exam. Graecum Hebraicum
Religion: None Protestant Roman-Catholic Islam Buddhism Hinduism _________________________
If you had to describe yourself: how religious are you?
not at all very
Self Description: What would you call yourself most likely? (tick only 3 at maximum)
Devout Christ Orthodox Jew Devout Hindu Devout Muslim Devout Buddhist Devout Shintoist Agnostic
Pagan Rosicrucian Thelemite Magician Hermeticist Alchemist Libertarian
Humanist Tantric Black Mage Witch Kabbalist Mystics LHP Mage
Nihilist Philosopher Freethinker Misanthrope Philanthropist Rationalist None of this
Own Designation(s): __________________________________________________________________________________________
How many hours can you make available DAILY for the occupation with the Hermetic Arts & Western Magic?
Less than 1 hour Maybe 1 hour Definitely 1 hour 1-2 hours 2-3 hours 3 and more hours
Why do you want to learn the Hermetic Arts & Western Magic theoretically & practically at the College IMBOLC?
What is/was the decisive point?
________________________________________________________________________________________________________
________________________________________________________________________________________________________
________________________________________________________________________________________________________
________________________________________________________________________________________________________
________________________________________________________________________________________________________
________________________________________________________________________________________________________
________________________________________________________________________________________________________
Do you have any prior knowledge or already acquired skills in the Hermetic Arts & Western Magic?
If so, where and how did you acquire it?
________________________________________________________________________________________________________
________________________________________________________________________________________________________
________________________________________________________________________________________________________
________________________________________________________________________________________________________
IMPORTANT!
Write a separate text (length: one page, font size 10 in font Arial or Times) on a topic (or topics) of your choice.
What do you want to tell us? - Please attach the text to this questionnaire.
Moreover, please also send us a copy of your ID card or driver's license in JPG format.
3
VOLUNTARY INFORMATIONS (Personal Details & Statements):
Food & Addictions:
Smoker (regularly) Alcohol (regularly) Marijuana (regularly) Vegetarian Vegan ____________________
Medicine (regularly): ______________________________________________________________________________________
Relationship Status: Single/voluntary Single/involuntary Married Polyamorous
Divorced Widowed Boyfriend Girlfriend
Own Statement: _______________________________________________________________________________________
Sexual Orientation: Hetero Homosexual Queer Bisexual _______________________________________
Housing Status: Alone Living with my parents Flat share Partnership Own family
Children: Biological children Children of other marriages Sponsorship Desire to have children
Animals (Species/Number):
________________________________________________________________________________________________________
________________________________________________________________________________________________________
Travelled countries:
________________________________________________________________________________________________________
________________________________________________________________________________________________________
How did you hear about IMBOLC?
________________________________________________________________________________________________________
If via the Internet: which terms did you enter into the search engine?
________________________________________________________________________________________________________
Your hobbies (please name favorites first):
________________________________________________________________________________________________________
What sports do you do?
None Indoor sports: _______________________________ Outdoor sports: _________________________________
How much time do you dedicate to your hobbies per week?
About 1 hour 1-2 hours 2-4 hours 4-8 hours 8-14 hours 14-28 hours more than 28 hours
Your favourite books or authors are? (please name favorites first):
________________________________________________________________________________________________________
4
Your favourite music, styles, bands is/are? (please name favorites first):
________________________________________________________________________________________________________
Your favourite Thinkers, Philosophers, Magicians, Sorcerers, Occultists or Hermeticians are?
________________________________________________________________________________________________________
Own additional informations:
________________________________________________________________________________________________________
________________________________________________________________________________________________________
________________________________________________________________________________________________________
________________________________________________________________________________________________________
________________________________________________________________________________________________________
________________________________________________________________________________________________________
________________________________________________________________________________________________________
________________________________________________________________________________________________________
________________________________________________________________________________________________________
________________________________________________________________________________________________________
________________________________________________________________________________________________________
________________________________________________________________________________________________________
________________________________________________________________________________________________________
________________________________________________________________________________________________________
________________________________________________________________________________________________________
________________________________________________________________________________________________________
________________________________________________________________________________________________________
________________________________________________________________________________________________________
________________________________________________________________________________________________________
________________________________________________________________________________________________________
________________________________________________________________________________________________________
________________________________________________________________________________________________________
________________________________________________________________________________________________________
________________________________________________________________________________________________________
________________________________________________________________________________________________________
Thank you very much for your cooperation and given information.
These will be definitely treated confidentially!
