Leak: Scientology Census 2012 Questionaire

Zhent

Leakus Maximus
We are updating our census information for the Church of Scientology. Please fill out the below information fully and click the submit button at the bottom. Please answer as honestly and correctly as you can. No personal or identifiable information is collected or requested for this survey.


How were you first introduced to Scientology? *


A Personality Test
An advertisement (Radio, TV, Print, Promo)
Lecture
Reading a Dianetics or Scientology Book
Through a Friend or Relative
Other:

What was your age when you first were introduced to Scientology? *

What is your age now? *

How long have you been in Scientology? *

What is your religious background? *

Protestant
Catholic
Jewish
Eastern (Hindu, Buddhist, Eastern Philosophy)
Muslim
None
Other:

Were you married prior to Scientology? *

Yes
No

Are you married now? *

Yes
No

What was your attitude toward Marriage before becoming a Scientologist? *

Vital
Desirable
Unwanted

What is your attitude toward marriage after becoming a Scientologist? *

Vital
Desirable
Unwanted

How many children do you have? *

What activities are your children involved in?

Sports
Art (including music and dance)
School projects
Community projects
Boy Scouts
Girl Scouts
None
Other:

What type of accommodation do you live in? *

Own a home
Rent a home
Staff housing
Rent an apartment

What is your education level? *

Some high school
Graduated high school
Some University (college)
Graduated University (college)
Some Graduate school
Completed Graduate School
Vocational training
Business School
Art School or Training

What was your average grade in High School?

A average or top grades
B average or 2nd highest grades
C average or 3rd best
D average or 4th best

What was your average grade in University (college)?

A average or top grades
B average or 2nd highest grades
C average or 3rd best
D average or 4th best

How has Scientology helped you in the field of education? *

Increased reading & writing ability
Better concentration
Increased ability to study
Increased ability to apply what I leared
Increased understanding of what is studied
Other:

What have your occupational gains been as a result of Scientology? *

Increased competence
More able to deal with stress at work
Improved relationships with other employees
Other:

What is your current occupation? *

Managerial position
Arts (all forms of art - design, music, writing etc.)
Owner or part-owner of company
Sales
Computers
Teaching
Medical (including nursing, dental etc.)
Construction
Student
Marketing & Advertising
Clerical
Secretarial
Communications
Law
Sports
Civil service
Armed forces
Technical & Engineering
Manual
Homemaker
Retired
Auditor
FSM
Other


Is your average yearly income? *

Above the national average
National average
Below the national average

Do you receive welfare? *

What has your absenteeism from work been in the last year? *

How has your state of health been since becoming a Scientologist? *

Sick less often
Stayed the same
Sick more often

How many car accidents have you been involved in per year prior to becoming a Scientologist? *

0 per year
Less than 1 per year
1-3 per year
More than 3 per year

How many car accidents have you been involved in per year since becoming a Scientologist? *

0 per year
Less than 1 per year
1-3 per year
More than 3 per year

How often do you exercise? *

What type of exercise do you do? *

Had you taken street drugs prior to being in Scientology *

Do you currently take street drugs? *

Have you used medical drugs in the past year? *

How often do you use alcohol? *

Do you have family members who are Scientologists? *

If so, which family member(s) are Scientologists?

Father
Mother
Sister
Brother
Spouse
Uncle
Aunt
Cousin
Grandparent
In-Laws
Children
Other:

How many books do you read per year? *

What is important in life? *

Living a life of honesty and moral integrity
Developing fully as an individual
Having something meaningful to work toward
Using my full potentials
Enjoying good health
Really helping others
Having loving relationships
Having a stable family life
providing for my family
Creating a future for my children
Having good, close friends
Having enough money to live well
Having new experiences and excitement
Having a steady job
Having the best things in life

What type of community activities are you involved in? *

Educational groups
Human Rights Groups
Community goodwill programs
Environmental/Conservation groups
Professional associations
Art Groups
Sports clubs/groups
Charities
Political parties/groups
Civic community groups
Trade/Business unions
Youth groups
Consumer groups
Women's League
None
Other:

Do you enjoy making a positive difference in your community? *

Do you feel that Scientology has made a great deal of difference in your life? *

Do you feel that Scientology has exceeded/met your expectations? *

Do you feel that auditing was helpful? *

Do you have a desire to continue auditing? *

Do you agree that Scientology teaches people to think more clearly? *

Please provide some basic information about yourself:

What Scientology Services have you done? *

Introductory Services only (Division 6 Services)
HGC Processing Services (Div 4 Processing)
Academy Training Services (Div 4 Training)

Your highest case level? *

Introductory Auditing
Purification Rundown
TRs & Objectives
Scientology Drug Rundown
Happiness Rundown
ARC Straightwire
On the Grades or completed the Grades
On or completed New Era Dianetics
Power/Power Plus
Clear
OT I-III
OT IV - OT V
OT VI - OT II
OT VIII

Your highest training level? *

None
Division 6 coureses
Student Hat
Pro TRs/Upper Indoc TRs
Pro Metering
Academy Levels 0-IV
NED / Class V Auditor
Class V Graduate Auditor
On or completed SHSBC
Class VIII
Other

What Country do you live in? *

Australia
New Zealand
Taiwan
Japan
United States
Other:

LOL what a silly census! Look at that question on car accidents! :hysterical:
Can see the PR headlines now... "Its a fact - Scientology reduces car accidents"
:eyeroll:

Oh and I love how there are no science or media occupations. Gee I wonder why...
 

Stat

Gold Meritorious Patron
Oh yeah, I got this one too in a mail few days ago!

I guess they want to know even from SPs these days... :melodramatic:

I even thought of filling it out and sending back for some enturb lulz,
but was too lazy at the moment, so my trash can ate the census. :biggrin:
 

Stat

Gold Meritorious Patron
What, are the compiling a new WIS book? This belongs in the Stupid Thread. :)

Haha! You made me laugh, Syn! :) Thank you!

Something tells me there will be no new WIS book or new Orientation film ever.

Oh, speaking of Orientation, little anecdote here.

About a year ago, right before my wife decided to stay with SP me and got declared herself,
she observed Dissem Sec saying "Thanks God!" with a huge relief, when she was told there will be
no more Orientation! LOL I guess she was getting really sick too of routing staff' kids to the film room
every Thursday before 2pm. My son watched Orientation at least 20 times, I swear.
Big thank you goes to Larry Anderson for leaving the cult! Even Dissem Secs love you for that!
 
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Stat

Gold Meritorious Patron
They should just mail you th Life History questions, why beat around the bush?

I know, right?! I had the same thought when I saw the Census and its questions.
Scientology has more intel on people then any gov agency. :coolwink:
 

Stat

Gold Meritorious Patron
Speaking of Life History: http://www.xenu-directory.net/documents/plummer-lhf.html

Life History


Name: _______________________ Date ________________________
today:
ASHO D Post ________________________
AOLA
(Answer questions on separate paper and attach)


PART I


1. Do you have a psychiatric/institutional history, or have
you ever been a social worker, psychologist or counselor
of any kind? Have you practiced any kind of group therapy?
A. If yes to any of the above, give time, place,
form, event and full details.


2. Have you ever had a willing connection to a squirrel group
or suppressive group?
A. If yes, give full details.


3. Have you ever blown from any Scientology or Sea
Organization? (even if only for a day)?
A. If yes, give full details.


4. Are you connected to anyone antagonistic to Scientology?
A. If yes, give full details.


5. Have you ever threatened or attacked Scientology?
A. If yes, give full details.


6. Have you ever been expelled from the Church?
A. If yes, give full details.


7. Do you have a criminal history of any kind?
A. If yes, give full details (time, place, form,
event).


8. Have you taken illegal drugs?


9. Have you completed the Drug Rundown? When?


10. Have you ever taken drugs since being in Scientology?
A. If yes, please state what drugs you took, and what
training and/or auditing you'd had, when and where
and under what circumstances you took the drugs.


11. Have you ever threatened or attempted suicide?
A. If yes, please give full details.


PART II


1. SCIENTOLOGY AND DIANETIC TRAINING.
Please list in chronological order exactly which Tech and
Admin training you have done. List should be date of
completion, Month and year. (For any courses not
completed, please give the date you started the courses
and note that they are incomplete.)


2. PROCESSING.
Please list in chronological order exactly what processing
you have had. Give the date (month/year) you completed all
actions and the date of starting any action which is not
complete. Include OT sections and any major rundowns.


PART III


1. When and where were you born?


2. Education: Please list in chronological order, beginning
with your earliest schooling, every school you have
attended. Use the headings as illustrated below.
DATES NAME OF SCHOOL LOCATION MAJOR STUDY


3. Employment: Please list in chronological order all jobs
you have held beginning with your first job. Please
explain what you were doing during any period of
unemployment. Use headings.


4. Medical history: Please list in chronological order any
illness, accidents, permanent injury, etc, you have had,
from birth to PT by month and year. Include all childhood
illnesses (i.e. mumps, measels, chicken pox, etc). List
the names and location of any hospitals and sanitoria you
have been in. State also the approximate frequency that
you have had colds, aches and regular pains during your
life, with the time periods. List also any corrective
surgery you have had and where done.


5. Please list your parents' names and adresses (or
guardian).


6. Please list your parents' PT occupation, and any other
jobs they might have held. Give a brief description of the
type of work they did, the name of the corporation, etc.


7. What is your attitude towards your parents, and what do
you think of them? How do they regard you?


8. Please list the names and adresses of your brothers and
sisters (if any), and what their job history is, where
they live and with who. What is your attitude towards
them?


9. List your friends (even prior to Scientology) and what
sort of relationship you had, and what sort of jobs they
held and are holding now. Also please state what your comm
has consisted of since being in Scientology.


10. What is your marital status? Please list the name of your
present spouse and any past spouses (in chronological
order if more than one), when you married him/her and
where. List also the dates of any separations and/or
divorces and why. (Give month/year for all dates and
maiden names where applicable.)


11. Give a general 2-D history for yourself, including your
earliest sexual experience of any kind, when you started
dating, and the names of all persons involved. Make a
chronological list by month/year of the names of all
persons with whom you have had sexual relationships and
what you engaged in. Approximate the number of times you
carried on any kind of activity, and note any perversions
you engaged in: WHO, WHAT, HOW OFTEN. Be as complete as
you can.


12. Note any instances of homosexual activity from earliest
time to PT. Give WHO, WHAT and HOW OFTEN.


13. List names and ages of children you have.


14. List your interests and hobbies.


15. List all groups and organizations you have ever been
associated with. Include time period, name of group, its
location, what type of group, and what you did in it.


16. List any connections to terminals listed in the following
groups.
A. Intelligence organizations
B. Organized medicine
C. Banking industry
D. The Media
E. Goverment
F. Public Relation Firms
G. Psychiatry, psychiatrists, psychologists, etc.


PART IV


1. How did you get into Scientology? Include who introduced
you, where and when and what this person is doing now.


2. When and were did you first start on staff in a
Scientology mission or organization?


3. Please list in chronological order all posts you have held
in any Scientology organization and mission. Use headings.


4. Please list any MAJOR ETHICS ACTIONS YOU HAVE HAD, good
and bad, and explain it fully.


5. To what org are you contracted and for how long?


PART V


1. Please list all drugs you have taken, including medicine
with month/yr time periods as closely as possible. Use
headings as in the illustration below.
DATE DRUG APPROX # OF TIMES


PART VI


1. Please give exact details concerning your current life:
whom you live with, whom you spent your free time with or
run around with, etc. What is your daily routine, what do
you do with your leisure time?


-------


If you are in the SO put down your rank and rating.
Sea Org Training? (include date) AB, SWBP, SOSS, PROD
0,I,II,III ore more?
What class missionaire? 3rd, 2nd, 1st? Are you mission
eligible?


List out any missions you were on with what conditions and when
that mission was. Also what position you held on the mission.
(IC, etc.)


Please attest the data is true and correct.



The above is a bit extended Scientology Census.
 

FoTi

Crusader
"We are updating our census information for the Church of Scientology. Please fill out the below information fully and click the submit button at the bottom. Please answer as honestly and correctly as you can. No personal or identifiable information is collected or requested for this survey."

So...they have your email address and sent this out to you. And....when you click on the submit button, they won't know who submitted or where the answers came from?

Well, at least they left off the questions about psych history and sex. But it seems to me that the rest of it is loaded with personal questions.

I HATED THAT LIFE HISTORY!!!!! I can't believe I consented to filling that thing out. I should have walked away right then.
 
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Purple Rain

Crusader
They should just mail you the Life History questions, why beat around the bush?

0511-0702-2316-3521_Head_Falling_Off_of_a_Businessman_Laughing_clipart_image.jpg


:laugh: Oh, Freethinker, I needed that! You can just imagine the results. Of the 3% of Scientologists who had sex with their gerbils ....
 

sallydannce

Gold Meritorious Patron
I just read the life history form and I've made a decision:

I'm now looking for a new group that will invade my head and my life as much as the cult did. I miss that ya know.

NOT!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!
 

Type4_PTS

Diamond Invictus SP
I notice that on the question "What is your religious background?" that 'scientology' is not one of the options. That's a strange omission, isn't it? Especially if sent to a 2nd generation Scientologist who probably was never exposed to any other religion other than scientology. (it's like they're acknowledging that Scn isn't a true religion) :biggrin:
 

Stat

Gold Meritorious Patron
I notice that on the question "What is your religious background?" that 'scientology' is not one of the options. That's a strange omission, isn't it? Especially if sent to a 2nd generation Scientologist who probably was never exposed to any other religion other than scientology. (it's like they're acknowledging that Scn isn't a true religion) :biggrin:

Haha! Eagle eye, brother, great point!
 

sallydannce

Gold Meritorious Patron
I notice that on the question "What is your religious background?" that 'scientology' is not one of the options. That's a strange omission, isn't it? Especially if sent to a 2nd generation Scientologist who probably was never exposed to any other religion other than scientology. (it's like they're acknowledging that Scn isn't a true religion) :biggrin:

Nah. I reckon it's just the work of an evil transcriptionist (sp?). Those beasts can cause a lot of havoc. Whole religions can nearly get wiped out by them. :eyeroll:
 

Stat

Gold Meritorious Patron
I just read the life history form and I've made a decision:

I'm now looking for a new group that will invade my head and my life as much as the cult did. I miss that ya know.

NOT!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!

I know exactly how you feel, Sally! lol

I love it how Hubbard writes (paraphrasing) "We don't care what you did in the past, as long as you are on board with us here and now" (some HCO PL in Staff Status I, me thinks) and forgets to mention that he also wants you to describe all the sexual positions with every male or female, on every account in Life History Form. Also, all your friends and also EVERYTHING from your past.

On a brighter note, may be that is how LRH was collecting data for his epic Mission: Earth decalogy. When I read some of the kinky parts of that piece of work by LRH, it was like stumbling upon some porn on the internet that you wish you didn't see, even if you feeling horny, nothing illegal, but a bit disturbing.
No wonder Scientologists don't talk about Mission: Earth much and I am pretty sure there are no plans to make a movie. :omg: :no: LOL :)
 

freethinker

Sponsor
Remember when Wister used the cleats of his sneakers to remove the face of the attackers of the woman proffessor. He was really into gore.
I know exactly how you feel, Sally! lol

I love it how Hubbard writes (paraphrasing) "We don't care what you did in the past, as long as you are on board with us here and now" (some HCO PL in Staff Status I, me thinks) and forgets to mention that he also wants you to describe all the sexual positions with every male or female, on every account in Life History Form. Also, all your friends and also EVERYTHING from your past.

On a brighter note, may be that is how LRH was collecting data for his epic Mission: Earth decalogy. When I read some of the kinky parts of that piece of work by LRH, it was like stumbling upon some porn on the internet that you wish you didn't see, even if you feeling horny, nothing illegal, but a bit disturbing.
No wonder Scientologists don't talk about Mission: Earth much and I am pretty sure there are no plans to make a movie. :omg: :no: LOL :)
 

sallydannce

Gold Meritorious Patron
I love it how Hubbard writes (paraphrasing) "We don't care what you did in the past, as long as you are on board with us here and now" (some HCO PL in Staff Status I, me thinks) and forgets to mention that he also wants you to describe all the sexual positions with every male or female, on every account in Life History Form. Also, all your friends and also EVERYTHING from your past.

On a brighter note, may be that is how LRH was collecting data for his epic Mission: Earth decalogy. When I read some of the kinky parts of that piece of work by LRH, it was like stumbling upon some porn in the internet that you wish you didn't see, even if you feeling horny, nothing illegal, but a bit disturbing.
No wonder Scientologists don't talk about Mission: Earth much and I am pretty sure there are no plans to make a movie. :omg: :no: LOL :)

Yeah, just a little contradiction there from Hubbard. Ya gotta laugh at the man, he was quite masterful with his blazing contradictions and not quite getting caught in the act.

I've never had the displeasure of reading Mission Earth. I tried reading the first one - got about two pages into it and just couldn't read it.
 

Stat

Gold Meritorious Patron
Yeah, just a little contradiction there from Hubbard. Ya gotta laugh at the man, he was quite masterful with his blazing contradictions and not quite getting caught in the act.

I've never had the displeasure of reading Mission Earth. I tried reading the first one - got about two pages into it and just couldn't read it.

Yep, LRH and his contradictions.

I've read 7 out of 10 volumes, I think. About 14 years ago.

I want to read it again, the whole thing this time, just to see how much I can take and also explore Ol' Man's creative mind a bit more. lol

Mr. Zhent, any mediafire suggestions, please? :)


P.S. Btw, the Mission: Earth 10 volumes (epic decalogy thing), could be easily a 3 volume thing. But you know. And if you don't - google anything ASI.
Oh, also ask Jefferson Hawkins. I love that SP! :)
 
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