Sea Org Life History Questionairre

J. Swift · Jun 12, 2008

Sea Org Life History Questionairre

Just in time for Sea Arrgh Saturday, June 14. Print it and give it to the media!

This Sea Org application come courtesy of oblivion. It is yet another unbelievably intrusive Scientology document. Anyone applying to enter the Sea Org must fill this thing out, and it includes an exhaustive 1D and 2D (sexual) history. The Cult wants to know each and every time a person masturbated or had sex. The Cult wants to know the the circumstances, fantasies, and the names of one's sexual partners. The Cult wants dates and times and places of each and every time one used their sexual organs and each of their orifices in a sexual way. The Cult wants to know one's sexual perversions and homosexual history. The Cult wants all medical and medicine history and everything else. If you f*cked a giraffe, the Cult wants to know. Aside from sex, the Cult really wants to know if one is connected to any SP's, such as the membership of EO!

LIFE HISTORY QUESTIONS
REVISION

NOTE: This life history must be written clearly and abbreviations must be avoided.

Name:

Date:

Mother's maiden name:

Previous last names:

___________________ _____________________
Name When used

DATE OF BIRTH:

PLACE OF BIRTH:

SOCIAL SECURITY NUMBER:

DRIVERS LICENSE NUMBER: _______________ _______________

Number State Expiration Date

Credit cards:
-------------------- --------------- -----------------
Brand Number Exp date

Bank accounts:
-------------------- -------------------- -----------------
Bank Number Exp date

Closest relatives or friends to contact in an emergency:

-------------------------------------- ------------------------------- -------------------------------------
Name (relationship) Address Phone Number

----------------------------------- -------------------------------- -------------------------------------
Name (relationship) Address Phone Number

Passport:
------------------------------ ----------------------- ------------------------
Number Country Expiration date

Visa:
------------------ -------------------- ---------------------- --------------------
Type Number Date issued Exp date

PART 1:

(When the answer is affirmative to any of the questions below, you are to include time, place, form and event)

1. Have you had an interview or treatment of any kind from a social worker, counsellor, psychologist or psychiatrist?

2. Have you ever been institutionalized in any type of rest home, psychological, psuchiatric or mental institution of any kind?

3. Have you ever committed another to a rest home, psychological, psuchiatric or mental institution of any kind?

4. Have you ever sent another to a psychologist or psychiatrist?

5. Do you have any training of any kind as a psychologist or psychiatrist?

6. Did you major in psychology at, for example, a college or university?

7. Have you ever undergone any electric, insulin or other shock treatment or psychiatric brain operation?

8. Have you ever been a member of a squirrel group? (Definition of a squirrel from Tech Dictionary: "Those who engage in actions altering Scn, and off beat practices.")

9. Have you ever had a willing connection to a squirrel or SP group?

10. Have you ever been enrolled in a suppressive group? (Definition of a suppressive group per HCO PL 29 June 68: "Suppressive Groups are defined as those which seek to destroy Scientology or which specialize in injuring or killing persons or damaging their cases or which advocate suppression of mankind.") If yes, give full details.

11. Are you or have you been connected to any person not in good standing with the Church of Scientology? If yes, names and connections.

12. Have you ever been declared an illegal PC?

13. Have you ever been denied processing by HCO, OSA or Senior C/S Int?

14. Have you ever been expelled from the church?

15. Have you ever been offloaded from the Sea Organization?

16. Have you ever been dismissed from staff of a Scientology org, mission, group, etc?

17. Have you ever been declared a suppressive person by the Church of Scientology?

18. Have you ever not been in good standing with the Church of Scientology for any reason not stated above?

19. Have you ever blown staff in any Scientology organization?

20. Are you currently blown from ANY Scientology organization?

21. Have you ever threatened to blow from any Scientology organization?

22. Have you ever deserted a Sea Org Organization?

23. Have you ever blown an auditing session, action or program?

24. Have you ever blown from a Scientology organization as staff or public for any reason (if not already described above)?

25. Have you ever had doubt about being in Scientology and/or the Sea Org?

26. Are you, or have you ever been a newspaper reporter or journalist of any kind?

27. Has your parrents or guardian ever been antagonistic towards Scientology?

28. Are you intimately connected with persons (such as marital or familial ties) of known antagonism to mental or spiritual treatment or Scientology? If yes, give full details.

29. Have you committed any criminal acts this lifetime for which you could be blackmailed?

30. Do you have a criminal record? If yes, give full details.

31. Have you ever threatened to sue or embarass or attack Scientology or Scientologists or ever been a party to an attack or threat? If yes, give full details.

32. Do you feel an auditor or a Scientology book is responsible for any unwanted condition you are in? If yes, give full details.

33. Are you being audited NOT on your own dterminism? If yes, give full details.

34. Have you ever NOT gotten gains which you expected from the Scientology training and processing you have received? If yes, give full details.

35. Do you have an open mind with no personal hopes or desires for auditing or knowingness?

36. Do you NOT feel anyone or anything can get better?

37. Have you ever sat in judgement on Scientology or Scientologists? If so, please give full details.

38. Have any of your family or close friends expressed skepticism or been critical of Scientology? Give full details.

39. Have you been or are you connected to anyone who has threatened or attacked Scientology? If so, give complete details.

40. Have you ever taken LSD? If so, give full details of how many times; over what period of times.

41. Have you ever taken Angel Dust? If so, give full details of how many times; over what period of times.

42. Have you ever had a full DRD declare and attested to a complete sweat out program?

43. Have you ever dealt in selling illegal drugs? Have you ever dealt in any activity connected to illegal drug sales or distribution? If so, give full details.

44. Are you an active drug pusher?

45. Do you have any connection to any person or group involved in the illegal sale or distribution of drugs?

46. Have you ever taken drugs since being in Scientology? If yes, state what drugs you took, what training and/or processing you'd had prior, and what training/processing you have had since that time, when and where and under what circumstances you took the drugs.

47. Have you ever had thoughts of committing suicide?

48. Have you ever threatened to commit suicide this lifetime?

49. Have you ever attempted suicide? If so, please give full details.

50. Are you related to or connected to intelligence agencies either by past history or immediate familial connections? If so, give full details.

51. Are you connected to or employed by any government agency, or have you ever been connected to or employed by a government agency?

52. Have you ever been employed by the government?

53. Have you ever been employed by a health clinic or institution?

54. Have you at any time been employed in, enlisted in, or pressed into military service of any kind?

55. Have you ever had any special military clearance of any kind?

56. Have you ever served in a high-security section of government or an armed service?

57. Do you have connections or vested interest which will or might result in personal profit to you as a staff member?

58. Are you in Scientology to obtain news stories or generally disrupt the Organization? If yes, give full details.

59. Are you in litigation with the IRS or any government agency?

60. Are you indebted to the IRS?

61. Are you in the country illegally?

62. Do you NOT have a valid and current passport?

63. Are yo ua minor without consent from your parents or guardian to be on staff?

64. Are you breaking the law by not attending school?

65. Have you ever had a Fitness Board turndown?

66. Hav eyou ever moonlighted?

67. Have you ever received a refund or repayment from any Church organization?

68. Have you ever threatened or demanded a refund or repayment from any Church organization?

69. Have you ever been involved in any form of mutiny?

70. a. Are you married/single/divorced/separated?
(Dates of marriage and divorce)

b. If currently, or ever, married, full name of (ex) spouse?

c. Does your spouse have any objection to your working in this
organization or expressed any opinion against Dianetics and
Scientology? If yes, give full details.

d. Wife's maiden name.

e. What is your relationship to your spouse, and/or ex-spouse?

f. If separated or divorced, any difficulties with your ex- spouse? If so give full details.

g. Is spouse or ex-spouse a Scientologist?

h. If divorced list reasons for divorce(s) and any emotional
feeling you have about it.

i. Do you have any children? If so, give details: Names, ages,
sex, do they live with you or not. (Put an X by the ones joining
the organization with you.)

j. What is your relationship with your children?

k. If divorced or separated, do you pay child support? Give
specifics.

l. If divorced or separated, do you have any legal obligations
or ties to your children? Give specifics.

m. Have any of your children (if any) expressed any objections
against Dianetics and Scientology or have any objections to your
working in connection with it? Give complete details.

n. If your children are not with you, how do you feel about
being separated from them?

71. List your parents' name and addresses. Please list your parents' PT occupations, 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. What is your attitude towards your parents, and what do you think of them? How do they [**note: the question ends like this on the form I have**]

72. List brothers and sisters and other relatives (Grandparents, Aunts, cousins, nephews, nieces). Note name, if Scientologist or not, what is his/her occupation, and current address.

73. List your friends (even prior to Scientology) and what sort of relations 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.

74. Has your mother expressed any opinion against Dianetics and Scientology, or does she have any objection to your working in connection with it? If yes, give complete details and what handling has been done.

75. In present time does your mother express objection regarding Dianetics and Scientology to you? If so, give full details.

76. Has your father expressed any opinion against Dianetics and Scientology, or does she have any objection to your working in connection with it? If yes, give complete details and what handling has been done.

77. In the present time does your father express objections regarding Dianetics and Scientology to you? If so, give full details.

78. Have nay of your relatives expressed any opinion against Dianetics and Scientology or have any objection to your working in connection with it? If yes, give full details.

79. Have you any marital or familial difficulties? If yes, give complete details.

80. With whom do you live?

81. Do you support yourself currently (food, rent, auditing, processing, etc)? If no, who supports you and what is the arrangement for same?

82. Do you receive income other than earned by the Church? If yes, give details.

83. Do you own a business which employs Church staff?

84. Do you have your own business outside the Church?

85. Have any persons you are connected to expressed any opinion against Dianetics or Scientology or do they have any objection to your working in connection with it? If yes, give full details.

86. Have you or any of your family members or close friends ever been connected to a government agency? If so, give full details.

87. How long have you been in Scientology?

88. Are there any cycles you would need to handle before being able to report for duty? (Please be very specific.)

89. Do you have any debts? Who to? How much?

90. Why did you join the Sea Org?

91. What benefit will you be to the Sea Org?

PART II:

1. SCIENTOLOGY AND DIANETICS TRAINING

Please list in chronological order exactly which Tech and Admin training you have done. List by date of completion, month and year (for any courses not completed, please give the date you started the courses and note that it is incomplete).

2. PROCESSING

Please list in chronological order exactly what processing you have had. Give the date (month and 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 schooloing, every school you have attended. Use headings illustrated below:

TIME PERIOD SCHOOL MAJOR STUDIES

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 periods of unemployment. Use headings.

TIME PERIOD COMPANY NAME TYPE OF WORK

3a. List any skills you have

3b. List any language you speak, and indicate whether or not you speak it fluently:

4. MEDICAL HISTORY:

Please list in chronological order any illness, accidents, permanent injury, etc., you have had, from birth to PT, by month/year. Include all childhood illnesses (i.e.: mumps, measles, chicken pox, etc). List the names and locations of any hospitals or sanitarium you have been in. State also the approximate pains during your life, with the time periods. List also any corrective surgery you have had and where done.

5. Give a general 2D history for yourself, including your earliest sexual experiences of any kind, when you started dating, and the names of all persons involved. Make a chronological list by month and year of the names of all persons with whom you have had sexual relationships anf what yo uengaged 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.

6. Note any instances of homosexual activity from earliest time up to PT. Give who. What done? And how often?

7. List your interests and hobbies.

8. 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.

9. List any connection to terminals listed in the following groups:

A. Intelligence Organizations
B. Organized medicine
C. Banking industry
D. Psychiatry, Psychiatrists, Psychologists, etc.
E. The Media
F. Government
G. Public Relation Firms

PART IV:

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

2. What were your reasons for becoming a Scientologist?

3. When and where did you first start on staff in a Scientology mission or organization? What were your reasons for joining staff?

4. When and where did you first start in the Sea Org?

5. Please list any major Ethics actions you have had, good or bad and explain them fully.

6. To what org are you contracted, for how long?

7. List in chronological order all post you have held in Scientology/Sea Org orgs.

PART V:

1. Please list all drugs you have taken, including medicine, with month, year, time periods, as closely as possible. Use headings as in illustrations below:

DATE DRUG APPROX # OF TIMES

2. Please list any major commitments you may have (e.g. debts).

3. Have you in any way ever been involved in any financial irregularities (e.g. off policy commissions and bonuses, theft of any org funds, unusual financial favors, unauthorized expenditures, etc.). If yes, include all details, no matter how small.

PART VI:

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

2. Please attest the data is true and correct-

Signed:________________________________ Date:_________________

DIANETICS, SCIENTOLOGY and SCIENTOLOGISTS are trademarks and service marks owned by Religious Technology Center and are used with its permission.

/////

anonyleaks · Jun 12, 2008

Re: Sea Org Life History Questionairre

This has been out for years ...

apownymous · Jun 12, 2008

Re: Sea Org Life History Questionairre

SOCIAL SECURITY NUMBER:

DRIVERS LICENSE NUMBER: _______________ _______________

Number State Expiration Date

Credit cards:
-------------------- --------------- -----------------
Brand Number Exp date

Bank accounts:
-------------------- -------------------- -----------------
Bank Number Exp date

HOLY FUCKING RED FLAGS, BATMAN.

Seriously, what the fucking shit?

The hazard potential of the FOUR OF THOSE BEING GIVEN TO SOMEBODY is off the fucking e-meters.

Edit:

c. Does your spouse have any objection to your working in this
organization or expressed any opinion against Dianetics and
Scientology? If yes, give full details.

. . .

m. Have any of your children (if any) expressed any objections
against Dianetics and Scientology or have any objections to your
working in connection with it? Give complete details.

Disconnection / fair game preparation anyone?

apownymous · Jun 12, 2008

Re: Sea Org Life History Questionairre

19. Have you ever blown staff in any Scientology organization?

If Yes, Pics or GTFO

Hostile · Jun 12, 2008

Re: Sea Org Life History Questionairre

lol at asking questions on your entire sexual history... and gay sexual history...

goldenrodanon · Jun 12, 2008

Re: Sea Org Life History Questionairre

That looks the same as the one required for regular (non sea org) staff too.

But the above questionnaire gives the sea org members a clean "out".

It's point number 8. They'd all have to answer YES to that one, since Davey has been "helping" with the tech.

number 6 · Jun 12, 2008

Re: Sea Org Life History Questionairre

Do you have the actual document with the questionaire? If so, you can scan it in and upload it onto megaupload as a pdf file.

thankyoujerrygarcia · Jun 12, 2008

Re: Sea Org Life History Questionairre

"58. Are you in Scientology to obtain news stories or generally disrupt the Organization? If yes, give full details."

well, umm

lulznw · Jun 12, 2008

Re: Sea Org Life History Questionairre

Has your father expressed any opinion against Dianetics and Scientology, or does she

AnonBuff · Jun 12, 2008

Re: Sea Org Life History Questionairre

7. Have you ever undergone any electric, insulin or other shock treatment or psychiatric brain operation?

YEAH, FUCK YOU DIABETICS!

shadowchaser · Jun 12, 2008

Re: Sea Org Life History Questionairre

Previous last names:

I was reading that and thinking, fuck they expect you to remember supposed past life names too...

Diabetes is psychosomatic remember, so insulin must be a psych drug.

D... · Jun 12, 2008

Re: Sea Org Life History Questionairre

Credit cards:
-------------------- --------------- -----------------
Brand Number Exp date

Bank accounts:
-------------------- -------------------- -----------------
Bank Number Exp date

I don't know how ANYONE can read this and go, "Yeah, this isn't a trap."

Captain Anonymous · Jun 12, 2008

Re: Sea Org Life History Questionairre

36. Do you NOT feel anyone or anything can get better?

I like this one. It is wonderfully vague.

"Well, I guess nothings going to get better, better join Sea Org lol..."

Mouseyhair · Jun 13, 2008

Re: Sea Org Life History Questionairre

Oh hi I copypasta'd the best parts.

Credit cards:
-------------------- --------------- -----------------
Brand Number Exp date

Bank accounts:
-------------------- -------------------- -----------------
Bank Number Exp date

10. Have you ever been enrolled in a suppressive group? (Definition of a suppressive group per HCO PL 29 June 68: "Suppressive Groups are defined as those which seek to destroy Scientology or which specialize in injuring or killing persons or damaging their cases or which advocate suppression of mankind.") If yes, give full details.

11. Are you or have you been connected to any person not in good standing with the Church of Scientology? If yes, names and connections.

25. Have you ever had doubt about being in Scientology and/or the Sea Org?

28. Are you intimately connected with persons (such as marital or familial ties) of known antagonism to mental or spiritual treatment or Scientology? If yes, give full details.

29. Have you committed any criminal acts this lifetime for which you could be blackmailed?

38. Have any of your family or close friends expressed skepticism or been critical of Scientology? Give full details.

74. Has your mother expressed any opinion against Dianetics and Scientology, or does she have any objection to your working in connection with it? If yes, give complete details and what handling has been done.

6. Note any instances of homosexual activity from earliest time up to PT. Give who. What done? And how often?

Donovan Cook · Jun 13, 2008

Re: Sea Org Life History Questionairre

anonyleaks;340858 said:

This has been out for years ...

number 6;342530 said:

Do you have the actual document with the questionaire? If so, you can scan it in and upload it onto megaupload as a pdf file.

THIS^^

I know I've read most of these 'questions' before....but don't remember where.

ARNIE!!!!

If I can get a scan, THIS will be my flier for innoculation!!:flowers:

One of my favs...

9. List any connection to terminals(soon to be dead people? computers? trains?) listed in the following groups:

A. Intelligence Organizations
B. Organized medicine
C. Banking industry
D. Psychiatry, Psychiatrists, Psychologists, etc.
E. The Media
F. Government
G. Public Relation Firms

Italics mine....lol

Plups · Jun 13, 2008

Re: Sea Org Life History Questionairre

104 questions in Part 1.

12 (11.5%) of them aimed at finding your SP's and setting you up for disconnection.

LIFE HISTORY QUESTIONS
REVISION

PART 1:

(When the answer is affirmative to any of the questions below, you are to include time, place, form and event)

27. Has your parrents or guardian ever been antagonistic towards Scientology?

28. Are you intimately connected with persons (such as marital or familial ties) of known antagonism to mental or spiritual treatment or Scientology? If yes, give full details.

38. Have any of your family or close friends expressed skepticism or been critical of Scientology? Give full details.

39. Have you been or are you connected to anyone who has threatened or attacked Scientology? If so, give complete details.

70. c. Does your spouse have any objection to your working in this
organization or expressed any opinion against Dianetics and
Scientology? If yes, give full details.

m. Have any of your children (if any) expressed any objections
against Dianetics and Scientology or have any objections to your
working in connection with it? Give complete details.

74. Has your mother expressed any opinion against Dianetics and Scientology, or does she have any objection to your working in connection with it? If yes, give complete details and what handling has been done.

75. In present time does your mother express objection regarding Dianetics and Scientology to you? If so, give full details.

76. Has your father expressed any opinion against Dianetics and Scientology, or does she have any objection to your working in connection with it? If yes, give complete details and what handling has been done.

77. In the present time does your father express objections regarding Dianetics and Scientology to you? If so, give full details.

78. Have nay of your relatives expressed any opinion against Dianetics and Scientology or have any objection to your working in connection with it? If yes, give full details.

85. Have any persons you are connected to expressed any opinion against Dianetics or Scientology or do they have any objection to your working in connection with it? If yes, give full details.

Stuka Junker88 · Jun 13, 2008

Re: Sea Org Life History Questionairre

35. Do you have an open mind with no personal hopes or desires for auditing or knowingness?

I love how this is set up as negative.

anonymusicz · Jun 13, 2008

Re: Sea Org Life History Questionairre

number 6;342530 said:

Do you have the actual document with the questionaire? If so, you can scan it in and upload it onto megaupload as a pdf file.

I do not have a paper copy in my possession anymore, but I can validate this document as being factual.

I know that doesn't help all that much, sorry.

Daywatch · Jun 13, 2008

Re: Sea Org Life History Questionairre

anonymusicz;343675 said:

I do not have a paper copy in my possession anymore, but I can validate this document as being factual.

I know that doesn't help all that much, sorry.

DOX INC

waiting wikileaks

so I've been told

Zak McKracken · Jun 13, 2008

Re: Sea Org Life History Questionairre

34. Have you ever NOT gotten gains which you expected from the Scientology training and processing you have received? If yes, give full details.

35. Do you have an open mind with no personal hopes or desires for auditing or knowingness?

Tarp.
If you got the gains you were expecting from #34, you FLUNK at #35.
If you WIN at #35, you FLUNK at #34.
.....

J. Swift: your transcription has lots of typoes.
This is among the reasons we'd feel more confident seeing the original.

SmellDriver · Jun 18, 2008

Re: Sea Org Life History Questionairre

n. If your children are not with you, how do you feel about
being separated from them?

So what, if you say you don't like it, they refuse you? My mind....it is boggled. How could anybody read this and willingly agree? Especially the bank info. "Just give us your credit card number and SSN, and the key to your safe deposit box, and..."

I'd make a joke about giving up your firstborn, but it sadly would not be a joke in this instance.:sad:

Grunce · Jun 18, 2008

Re: Sea Org Life History Questionairre

shadowchaser;342859 said:

Previous last names:

I was reading that and thinking, fuck they expect you to remember supposed past life names too...

Diabetes is psychosomatic remember, so insulin must be a psych drug.

No, this is actually less stupid than it appears at first. Look at the way the question is phrased:

"Have you ever undergone any electric, insulin or other shock treatment or psychiatric brain operation?"

If expanded, that would read:

"Have you ever undergone any electric shock treatment, insulin shock treatment or other shock treatment or psychiatric brain operation?"

Although it's mostly forgotten about today, insulin shock treatment was at one time used for many of the same disorders as electric shock treatment. I'm not sure of the reasons it fell out of favor (and the Wikipedia article, predictably, has a Scilon 'it was only ever used because of the cruelty of psychs' whiff about it, so I'm not about to trust their account) but for whatever reason, it stopped being done and now most people when they hear "shock treatment" are unaware that there ever was any type other than electric.

supafreak · Jun 18, 2008

Re: Sea Org Life History Questionairre

Thank you for posting these.

Geez, they don't want to know much, do they? How does anyone remember what medications they've taken throughout their lifetime? And also, who cares? Madness!

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Sea Org Life History Questionairre

J. Swift Member

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