Give this check in exactly the same way as HCO WW SECURITY FORM 7A.

Failure to pass one or more questions on this check results in non-acceptance of this student on course until processing has been given.

The security checker does not attempt to clear or process any of the following questions if they produce instant needle reaction. Clearing questions is an auditor’s job and is done in an auditing session, not while receiving this check.

If a question produces instant needle response, clear it word by word and phrase by phrase until all phrases and words are as null as they can be made. Then test for reaction to the whole question. If it reacts it is a flunk.

The whole test is always completed. It should take 10 to 20 minutes at the most. Read the following to the student applicant:

“There is nothing personal about this check. It is for your protection as well as others’. If you pass it you have no worries. If you flunk it you will not be accepted on this course until you have been processed on your own arrangements. Here is the check. You do not have to answer anything if you do not care to.”

1. Have you ever committed any criminal act for which you could be blackmailed now?
2. Do you or your close family currently have any connection with organizations violently opposed to L. Ron Hubbard?
3. Are you here purposely to upset or damage Scientology or Scientology Organizations?
4. Have you ever cautioned anyone about following L. Ron Hubbard’s directions or data or told them not to?
5. Have you ever maliciously criticized Scientology, its organizations, data or people to people outside these organizations?
6. Do you intend to use people you meet here to secretly further your personal gain outside this course?
7. Do you feel Scientology is a fraud or racket?
8. Do you think it really doesn’t matter whether you do a good job or not?
9. Do you intend to quit this course just as soon as you have achieved your own ends?
10. Are you or have you been a Communist?
11. Are you wanted by the Police?
12. Have you come here with the intention of having sex?
13. Have you come on this course to create trouble, directly or indirectly, to Scientology?
14. Has some group opposed to Scientology, as it is presently practiced, sent you on this course?
15. Do you intend to use any information gained on this course for any devious purpose?
16. Have you come here to prove to yourself or others that Scientology does not work?
17. Are you presently under medication or treatment?

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Passed Security Checker

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Failed Date

Findings and Decisions: __________

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