Issue '105

DIANETICS AND SCIENTOLOGY QUESTIONNAIRE

I would like you to do me a favor. It won't take much ofyour time and will only cost you a stamp. This, to me, is avery important favor and would assist me greatly.

The favor I am asking of you is to fill out the questionnairescontained in this issue of ABILITY and return it to me .

This issue is being sent out to everybody who has ever ex­pressed any interest in Dianetics and/or Scientology whatsoever.I want eve'rybody -- old timers, newcomers, professionals, non­professionals, even Organization Staff members _-- to answerevery question which applies to himself and return this ABILITYto me as soon as possible.

Over the past nine years Dianetics and Scientology Organi­zations have served in many ways hundreds of thousands ofpeople. We have many files and records on these people andyou are one of them. We want to be very sure that these recordsare factual and accurate in every way.

We try very hard to maintain a high degree of accuracy butsometimes we slip up unknowingly. This we wish to rectifywhere there are any omissions or mistakes. A.ny informationyou give us will be held in the strictest confidence and will notbe released to anyone outside of the Director of Training, Dir­ector of Processing, Central-Files-in-Charge and myself.

We pride ourselves on the fact that no one outside of Staffmembers has ever had access to our files. Many people havetried in many ways to acquire the information that is in our filesand they all have failed. We feel that your Training Reports,Processing Reports, Correspondence and any other records wemay have concerning you are a private matter between you andus and should be held in the strictest confidence; which they are.

You are in our records only because at one. time or anotheryou have expressed interest in or participated in Dianetics and/ or Scientology.

ABILITY MagazineThe official publication of Dianetics and SGientology

FOUNDER: L o Ron Hubbard - EDITOR: Elanore Eddy© L. Ron Hubbard 1959

All Rights Reserved® Trade Mark Reg. U. S. Pat. 011.

2W ill you please fill in the the following information:

Please print.

What state do you reside in ? (Our address-o-graph is state­coded)

N ame --==~------__::'__:;_:__:;_:;'_:;__---

Last First MiddleAddress

Telephone Number Age Sex _

Occupation _

Please fill in the above regardless of any further questions asked.

I would like to ascertain first whether or not you wish to re­·main on our records, continue to be corresponded with, and toreceive our magazines and information. If you are not interest­ed any longer we will remove your name and address from ourfiles and will not send you any further literature. We naturallydon 't want to do this, but if you do not desire our communi-cations, we will do it for you.

I am , I am not interested in Dianeticsand/ or Scientology.

If you are not interested at this time, please feel free inthe future to contact us. We will always be happy to help youin any way we can.

In any event, if we do not hear from you within 90 days fromthe time you receive this booklet, we will remove you from ourrecords and files. The reason being that we wish to be able toserve those people who are interested more efficiently and notbother you any further.

Do you hold an HCO Franchise? Yes _ No---If yes, then what date was it put into effect.?~-~_--~~~If not, are you interested in further information about an HCO

Franchise? Yes No----If yes, I will forward your name and address to England andHCO WorldWide will write to you.

Have you ever been a member of a Dianetics and/ or Scien-tology Group? Yes No Are you presently amember of a Group? Lay Group ? Professional Group

?--~Group IS Name _

Number of persons in Group _Do you know of any Group that has disbanded? Yes _

No If yes, could you please furnish the name and ad-dress of one of the Group rnembers?

3

Name-----------_. Address-------------Would you be interested in starting a Scientology Group?

No previous training or processing necessary. Yes .No. If yes, 1 111 inform our Group Secretary and he willcontact you.

Will you please list below the various items in the way ofInformation Packets, etc., such as Problems of Work, Funda­mentals of Thought, Ability Magazines, etc., that we have sentto you free of charge.

If you haven It received one of these, would you like to receivean Information P~cket? Yes No If so, we willsend you one.

The questionnaire headed "The Distribution Center, Inc ",which begins on the following page concerns Dianetics and Scien-tology books and other materials. The Do C. 10 would very muchlike to know what Books and other materials you have purchasedin the past, what books and materials you have on hand, and whatbooks and other it ems you want in the future. This will help themto plan on what to keep in stock.

4THE DISTRIBUTION CENTER, INC.

Distributors of Dianetics and Scientology BooksBox 242, Silver Spring, Maryland, U. So A o

A. Materials you have purchased.B. Materials you still have on hand.C. Material you wish now or in the future.

ABC BOOKS by L. Ron HubbardProblem s of Work...•......•.•..•••.••.••. $ 1. 25Dianetics: Modern Science of Mental Health..• $4. 00Science of Survival•••.••••••..••.••..••••.. $ 7. 50Advanced Procedure & Axioms ..••.•.•.••••. $2.50Diane tic s I 5 5. . • • • • . • • . . • • • . • . • • • • • . . • . • . . . $3. 00Scientology: 8 -80.•••••••••..••.•.••••••••.. $ 1. 25Scientology: 8-8008••..••.....• 0 ••••••••••••$3. 50History of Man••••••.• 0 •••••• 0 ••••••• 0 •••••$3. 00Creation of Human Ability.••.••• 0 •••••••••••$5. 00Scientology: Fundamentals of Thought. 0 •••••• $ 1. 25PAB Books #1, 2, 3, 4,5 - each...•••••.•••••• $ 1.25Clear Procedure, Issue One...•.••..•••••.••$2.00ACC Clear Procedure of Oct. 15, 1958•••••••• $1. 25The Original Thesis•.•••.•••..•..•••••.•.•• $2.50Handbook for Preclears .•....•••.••••.•'••...$2.50Self Analy sis. • • • • . • •• . • . . • • • 0 • • • • • • • • • • • • • • $2. 50Self Analysis (British edition, hard cover) .... $3. 00How to Live though an Executive... a ••••••••• $2. 00

0 __1I 0

Ern

Special Reprints by L. Ron HubbardScientology: Evolution of a Science (from the first

Astounding SF article) ..••.•.•• 0 ••••••••• $ 1.25Scientology: Science of Certainty from Journal of

Scientology) •.••.••...... 0 •••••••••••••• $ 1. 25

The Clear (chapter two of Dianetics: ModernScience of Mental Health•.••••••.••.•.••. $ . 05

About World ProblemsFortress in the Sky by L. Ron Hubbard••••••• $ . 50All About Radiation••.••..•••.•••• 0 •••••••••$3. 25

About ScientologyACe Manual (com.pliedby· ACC Instructors) ... $ 1. 25Control & Mechanics of SCS (from L. R:.

Hubbard1s lectures•...•...••.• a ••••••••• $1.25HAS Training Manual (complied by L. Ron

Hubbard, Jr. and John Galusha) .••• 0 ••••• $ 1.25Notes on the Lectures of L. Ron Hubbard (com­

piled by Staff Los Angeles 1951) ••••••••••• $2. 00

o I

I 10

t=EE1----1-0

,,---,-_0

CIIJI 0

Child Dianetics (staff written, introductionby L. Ron Hubbard) ....•....••...••...•. $2.75

Creative Learning by Silcox & Maynard.. 0 ••• $3. 00

Summary of Scientology by Jack Horner ..•..• $1.25Scientology: Its Contribution to Knowledge by

U. Keith Gerry•.••..•.••.••.•••.•..••.• $2. 50Intentions - poems by Julian Cooper•••••••.. $2. 00

HA VE YOU LIVED BEFORE THIS LIFE? New!(will be in stock soon) Factual accountsOfover 40 past lives incidents. Introduction byL. Ron Hubbard....•....•..•••...•..... $3.75

Group Auditor IS Handbook #1. • • • . . • . • • . • . .. $2. 85

Brochures and PamphletsAssist Sheet...••.••.•.•.. 0 •••••••••••• no chargeDianetic Processing••......•..•.... 0 • • • • •• $ . 50Education and the Auditor.....•...••..••... $ .35Lecture Course Booklets (limited supply) each $ . 50Excerpt from Fundamentals of Thought... 0. $ . 05Excerpt from Problems of Work...•........ $ .05Church of Scientology Brochures #1,2,3, 4, each . 05P. Eo Booklet --New--per hundred•••.•••••• $ 25.00

Scales and ChartsChurch Creed.•.• 0 ••••••••••••••••• " •••••• $ 1. 25Tone Scale (black and white). 0 •••••••••••••• $ 1. 00Tone Scale (colored) •..••..••••••.••••••••. $ 1.00Chart of Attitudes •• 0 •••••••••••••••••••••••$ .50Chart of Human Evaluation•. 0 •••••••••••••••$ 1. 00Rights of a Field Auditor•....••••••.••.•••• $ 1. 00

Photos, DecalsPhoto of L. Ron Hubbard, bust•••. 0 ••••• 0 •••• $ 1. 50Church of Scientology Decals .•.•.••.••..• 0 ••$ .60

Discounts apply on above items. The itemsbelow are for sale, but discounts do notapply.

LP RecordsClearing Congress July 6, 1958 - 3 hours of

lectures by L. Ron Hubbard. Album•.....$8.00Individual Clearing Congress Records ("Violence",

"The Magic Button", flThe Goal of Auditing rr )

by L. Ron Hubbard.•..••..•••..••...••. $3.00"Leadership" lecture from Success Congress,

Jan. 4, 1959 •••.•$3.00London Clearing Congress Album - 6 hours of

Lectures by L. Ron Hubbard•••.•••..••. $24.00

5

6 Pocket BooksFear - fiction by L. Ron Hubbard.•••• 0 ••••• $ . 35The Great Religions by which Men Live .•.••. $ .35St. John 0 • .'. • • • 0 • 0 0 • • • • • • • • 0 • • • • • • • 0 • • • • • • $ • 50

Scientology Key Cases, Auto Emblems, etc.Scientology Key Case•..•••••••.•••••••...• $ • 49Scientology Identification Case•.••••••••••• 0 $ . 98Scientology Secretary•.••..•••.••••. 0 •••••• $1. 22Clergy Auto Emblem (to Ministers only). 0 ••• $3. 50Minister Pins (available to CAS and FC Ministers

only) ..••..• 0 ••••• 0 ••••••••••• 0 •• 0 ••••• $3. 75Professional Auditor Badge ( pin- available to

Professional Auditors only) .•••••.•••.••.• $5. 00Minister·s Cross and Chain (available to Ministers

only) ..•.••••..•••••..•••...•..•.•••. 0 $ 20. 00

Collector s I ItemsDianetics: Modern Science of Mental Health

(Morocco bound) ••••••••.•.•••••• 0 •••••$ 75. 00Technique: 8-88, handwritten (not available in

any other publication) •.••••.••••••••••• $ 25. 00

In order to give you better service in the future, we wouldappreciate your answering the following questions concerningthe past service you have received from the D. C. I.

Have you ever ordered any materials from Do C. 10 and neveras of today, receiv.ed them.? Yes No _

If you answered uyes", please fill out the following:

Name of item------------------------Date ordered---------Price What was the method of payment?Cash Check Money Order _Credit Slip Charge 0 C. 0

0D. _

To what address did you send the order?

If you have had more than one item you have ordered and notreceived, then please list them here:

Item Price Date order sent by you

I

-,'

7TRAINING QUESTIONNAIRE

I have , I have not received training in Dianeticsand/ or Scientology.

If you have not received training then please leave the remain­der of this questionnaire blank and go on to the next questionnaire.

PERSONAL TRAINING DATA. Please fill out where applicable.

1. I have never received formal training in Dianetics and Scien-tology: I have done "book auditing" from to _

2. I received training toward the following certificate (s): _List Certificates/Degreesfor which trained: I received this training from:

Name of Instructoror Dir. of Training Date began Date ended

No B o Please include the Extension Course, if applicable in thiscategory.

I currently hold the following Certificates/Degrees.

NAME NUMBER ISSUED DATE CITY of ISSUANCE

8I a-n incomplete or due the following Certificates/Degrees:NAME DESCRIBE WHY NOT RECEIVED BRIEFLY

GENERA.L COMMENTS: In this space write in any cOtnments,complaints, or suggestions you may wish to about Trainingand/ or C ertific ation:

My current and/or future plans for Training are

Signed --- _

Thank you for your co-operation.

This information is very valuable and will assist us to renderthe field better service in the future.

Sincerely,

Director of Training

PROCESSING QUESTIONNAIRE

I have , have not received Dianetic or Scien-tology processing.

9

If you have not received Dianetic or Scientology processingof any kind, just check the above statement and leave the remain­der of this questionnaire on processing blank.

In the space provided below, list any auditing you have had.There are many types of auditing and, for convenience on thisform, we will designate them as follows: A - auditing receivedat a Hubbard Guidance Center or other Central Organization pro­cessing center; B - auditing received from a certified auditorin the field; C - auditing received as part of an auditor trainingcourse; D - auditing received from an untrained auditor; E ­auditing as a member of a co-audit team; F - auditing receivedas a member of a group being group audited; G - auditing re­ceived by means of tape recording; H - auditing received in anHAS Co-Audit; I - auditing received via self processing books;J - auditing received which fits none of the above classificatiolls.

Fill in all appropriate blanks:

Type Person in Charge ­Dir. of Processing,Instructor or GroupLeader

Auditor Dates City &State

Dianeticor Scien­tology· .auditing

10 MEMBERSHIP QUESTIONNAIRE

If you have never held any type of member ship in a Dianeticand/or Scientology Organization, please check here-----

Please indicate the type of mem.ber ship yo u have held but nolonger hold with an "An and mark the memberships you now holdwith a "B".

Check where applicable with either an A or a B.Expiration Date

Founding Membership •.•.•....••.••.•.. None••..•.•

International·Mem.bership •••.•.. 0 _

Participating Membership .0 ••••• _

Associate Membership •••.••..••••.•••• None•••.••.

Professional Membership ••.••• 0 • _

Special Membership •...•..•..••• _

___ General Membership 0 ••••••••••• _

Church of American Science .•••. _

Church of Scientology •.•....•.•. _

HDRF Membership 0 •••••••••••• _

If you have held a type of membership in any Dianetic and/ orScientology Organization that isn It listed here then please fillin the following information:

Name and address of Organization Membership is or was held

in:

Date Member ship expired/ expire s _

CONGRESSES

Have you ever attended a Congress or Conference of Dianeticsp.nd/or Scientology? Yes No _

11

If no, do you ever plan to attend one? Ye s _ No

If you answered yes to question one, then please go on withthis questionnaire.

Please check where you attended.CHECK PLACE DATEHERE

Elizabeth, N. J. 0 •• 0 ••••••• ,

Los Angeles o •••••• 0 ••••••• _

• • 0 •• 0 •••••• 0 ••••••••• 0 ••••-----------Wichita, Kansas .••• 0 ••• 0 •• 0 • _

• 0 0 •• 0 •• 0 • 0 ••• 0 0 •••• Oi'. 0 ••••-----------Phoenix, Arizona ••••••. 0 •••

------~--

• •••• 0 ••••••••••••••••••• 0 •-----•• 0 ••••••••••••••••••• 0 •••••••••-------------,

____v •••• Philadelphia, Pa•••.••••.•.. _

_: __ v •••• Washington, D. C•••....•••.• _

••••••••••••• 0 •••••••••••••••••••-----------• II •••••••••••••••••••••• 0 ••••••••-----------• 0 •••••••••••••••••••••••••••••• -----------•• 0 •••••• 0 ••••••••••••••••••••••-----------................................-----------................................

----------~-

.................................-----------

........................ ' .-----------Please write in the names of any other cities in which you haveattended a Dianetics or Scientology Conference or Congress.

- APPLICATION BLANK -

CONGRESS ON"THE STATE OF MANrr

*** At the Shoreham Hotel, Washington, D. C., January 2 & 3, 1960 ***L. RON HUBBARD, FOUNDER OF SCIENTOLOGY, WILL BE HEREIN PERSON TO LECTURE TO YOU ON THE STATE OF MAN.

- In addition to many other Congress features -

CONGRESS PRICES: Non-Members: $50.00 single person - $75.00 coupleM·embers: $35.00 single person - $60.00 couple

($ 10. 00 for children under 16 year s)(Nursery facilities available at no extra charge to you. )

Shoreham Hotel rates!or Congress Delegates:

Single rOOnlS - - $ 90 00 per dayDouble rooms - - $14. 00 per day(Write to the hotel in advance for reservations)

SUGGESTION: If you want to make it lighter on your pocketbook atChristmas time, pay for your Congress NOW -- make payments fromnow until the Congress, weekly or monthly, or all at once, as youchoose.

I (we) wish to attend the Congress on THE STATE OF MAN to be held January 2&3, 1960 at the Shoreham. Hotel in Washington, D. C.

Name Name

Address A.ddress

Nam.e Name

Address Address

Name Name

Address Address

I enclose $ , Congre ss fee in full.I enclose $ , payment on my (our) Congress fee, and will remit the

balance between now and January 2, 1960.

(Make your check or money order payable to: "Congress of Scientologists fl )

Signature

Street Address

Name (please print)

City and State

Return Application Blank to:Registrar

CONGRESS OF SCIENTOLOGISTS1812 19th Street, N. W·.

Washington 9, Do Co