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Dear Member,

This annual IAS Census gathers important data from you to help chart future plans and expansion and helps us provide you with the best possible service as a member of the IAS.

This year we celebrate the 30th Anniversary of the IAS, a major milestone in our history. We thank you for your support of the IAS and for answering the census. We look forward to your reply!


Desiree Tauzin
Director of Membership Services
IAS Administrations

Your Info (Fields marked with "*" are required)

If your address has changed from the address the census was mailed to, please enter your new address info below:

* First Name
* Last Name
Address (optional)
Address Line 2
State or Province
Zip or Postal Code
Home Phone
Mobile Phone
Office Phone
* Your E-mail
(Keep up-to-date with the latest news on IAS-sponsored campaigns)
Language Spoken

Your Views

1. What made you decide to become an IAS member when you did?
2. What is most valuable to you about being a member of the IAS?
3. What do you consider is the most important program or campaign that the IAS is currently supporting?
4. If you have attained an IAS Honor Status, what was it that made you decide to take that step?
5. If it were possible to make automatic monthly IAS donations of any amount you choose, would you be interested in doing so? Yes No
6. Do you receive IMPACT magazine? Yes No

If YES, do you read it? Yes No Partially

If YES or PARTIALLY, what interests you the most about IMPACT magazine?
7. Is there any topic or subject you would like to see covered in IMPACT magazine?
8. If an electronic version of IMPACT were available, would you download and use this?
Yes No
9. Is there someone you know of who you think deserves an IAS Freedom Medal or has the potential to win one in the future?
10. Do you know of people who are very active in any of the Fourth Dynamic Campaigns whose activities would make an interesting story for IMPACT or a future event? If so, please give their names and any data you have about their activities.
11. Is there anything about the International Association of Scientologists that you would like more information about or any questions you would like to ask?

Service to You

1. Which IAS Membership or Honor Status do you have?
Free Six Month Membership Annual Membership Lifetime Membership
Sponsor Senior Honor Roll Patron Meritorious
Crusader Patron Silver Meritorious or Above
Honor Roll Patron with Honors
2. If you are married, please list the names and memberships of your spouse and children:
3. Do you have your IAS membership card? Yes No
4. Do you receive duplicative mailings from the IAS? Yes No

(if YES, give specifics so this can be corrected)
5. If you have an Honor Status in the IAS:
  1. Did you receive your pin? Yes No

  2. Did you receive your plaque (or trophy)? Yes No

  3. Were you awarded with your status at an IAS dinner or Patrons Ball? Yes No
6. What is your birth date?
7. What is your occupation?
8. What is your case level?
9. What is your training level?
10. Your Org or Mission?
11. Are you currently taking services? Yes No
If yes, which service?
12. Are you: Org staff Mission staff Sea Org member

IAS Field Disseminator Program

If you are not an IAS Field Disseminator:

1. Are you interested in receiving information about the IAS Field Disseminator program and how you can earn commissions for assisting others to become members and for raising funds for the IAS?
Yes No

If you are an IAS Field Disseminator

2. Is there anything you would like assistance with or more information on?
3. Have you done the new IAS Field Disseminator Enlightenment Hat? Yes No
4. If not, would you like to be sent one so you can do it? Yes No
5. Are there any Field Disseminator Awards or commissions you have earned but not received?
6. Would you like to be added to the Field Disseminator mailing list to receive special updates about the IAS?
Yes, send by mail Yes, send by email Yes, send by both mail and email No

Your Plans for the Future

1. Do you want to advance your IAS membership or Honor Status? Yes No
2. What would be most important to you about moving up to a new IAS status?
3. How would it benefit you personally?
4. How would it benefit others?
5. What are your plans for advancing your IAS status?
6. Are you qualified for the Sea Org?
Yes No
7. If you are qualified, have you considered joining the Sea Org or made plans to do so?
Yes No

Thank You!

Thank you very much for filling out the IAS 2014 census!

Please let us know if there is anything else you would like to communicate to the IAS or any assistance you need as a member.

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