Date: Full Name:
Nickname or Magickal Name:
Origin:
City, State, Zip: Country:
Email:
Homepage or URL (if applicable):
Age ___________ Give month and year ________________ If you are under legal age we must have parental consent.

1. What are your beliefs? (In complete form, you may use a listing manner if you are more comfortable. Be sure you use your own words to explain your beliefs.)

2. How long have you had your beliefs?

What are the origins of your beliefs? (Where did they come from)

3. How do you apply them in your daily routine?

4. What were your previous beliefs?

5. Why did you change them?

6. What does God mean to you?

7. What does Satan mean to you?

8. What does Magic mean to you?

9. Have you ever practiced Magic? ____________In What forms?

10. What were your results? And what happened during the ritual or spell?

11. Do you feel the need to lean on something or someone? __________If yes, who and why?

12. Name three things you are interested in learning more about. 1. 2. 3.

13. What are you hoping to gain from joining the Cove?

14. List any other organizations you may be a part of (past and present)

15. How did you hear of us?

16. If a member referred you to the Cove, name that person.

This application must be copied and pasted to your email program and sent to H.P. Ravencia (H.P. Cyn).

This form must be completed in full and either given or sent to us. All information contained herein is held strictly confidential and will not be released to anyone without the approval of the individual that is named within. All blanks must be filled in for you to be considered for membership within the order. It may take up to 10 days after receiving the application for a decision to be made.