1. You have recently undergone or in the middle of a major life change such as...
Divorce
Relationship Breakup
Financial Crisis!
Illness
Moving
Job Change
Marriage
Death of a Loved One
 
2. You are passionate about a particular cause, belief, or idea.
Yes
No
 
3. You are intrigued with new ideas and unusual ways of looking at things.
Yes
No
 
4. You are currently bored with life and looking for new adventures.
Yes
No
5. You have advanced education.
Yes
No
 
6. You come from a fairly normal and stable family that encourages self-exploration.
Yes
No
 
7. You come from a dysfunctional family that has imposed unreasonable restrictions.
Yes
No
 
8. You are disillusioned with some aspect of your life such as
Job
Relationship
Spirituality
Physical Fitness
Political Agenda
Leisure Activities
Current Living Conditions
 
9. You are going through a period of self-examination and actively looking for new ways of personal development.
Yes
No
 
10. You spend a lot of time online looking for advice for health problems, spiritual guidance, or friendship.
Yes
No
 
11. You have been hurt by your church, temple, or mosque and are seeking new spiritual experiences.
Yes
No
 
12. You are homeless or have been homeless.
Yes
No
 
13. You are wealthy or have a well-connected family.
Yes
No
 
14. You have recently hired a stranger for help with childcare, yard work, housework, or construction projects.
Yes
No
 
15. You have friends, teachers, co-workers or neighbors whom you suspect are in a cult.
Yes
No
 
16. You have friends, teachers, co-workers or neighbors who are in a cult and you don't know about it. (Mandatory check mark for this question.)
Yes
 
17. There is someone new in your life who is demanding more and more from you, making you feel inadequate and guilty when you don't measure up to those demands.
Yes
No
 
18. There is someone new in your life who is inflating your ego by "pointing out" how misunderstood or special you are, and making disparaging remarks about your current friends and family members.
Yes
No
 
19. You have fallen in love with a cult member.
Yes
No
 
20. You are new on campus and looking for groups to join.
Yes
No
 
21. You are new on campus and cults are looking for you. (Mandatory check mark for this question if you are a college student.)
Yes
No
 
22. You are isolated and lonely.
Yes
No
 
23. You don't know about cult recruitment techniques.
Yes
No
 
24. You don't believe cult recruitment can happen to you.
Yes
No
 
25. You have a special skill or experience that a cult wants. (Mandatory check mark for this question.)
Yes
 
26. You can fog a mirror. (Mandatory check mark for this question.)
Yes
 
27. You DO know about cult recruitment techniques.
Yes
No

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