The New England UFO Research Organization Sighting Questionnaire
(See "Contact Information" for the mailing address)
(This Confidential report for New England UFO Research Organization Use Only):
Place of SightingState/Province: _____________________ County: _____________________________ City/Town: __________________________ Country: ____________________________
Time of Sighting_____________ p.m.( ) a.m.( ) Time Zone: _________________ Duration: ______ seconds( ) minutes( ) hours( )
Date of SightingDay: ___________ Date: __________ Month: _________ Year: __________
WeatherTemperature: ___________________ Wind Direction: ________________ Wind Speed: ____________________ Visibility: ____________________ Ceiling: _______________________
(This information is for Mass. MUFON's files ONLY and will not be publically available;
any reference to this case will be by case number only, not name)
Witness' Name: ________________________________________ Age: ________ Street Address: _______________________________________ Town/City: ____________________________________________ State/Province: _______________________________________ Country: ___________ Telephone Number: _____________________________________ Occupation: ___________________________________________ Employed By: __________________________________________ Education: ____________________________________________ Degree: _______________________________ Major: _______________________________ Special Training: _____________________________________ Vision: ______________________ Color Blind?: ________ Eyeglasses?: ________ Hearing: Good?: _______ Fair?: _______ Poor?: _______ Use Aid? _______ Health: During Sighting?: _____________________ After?: _____________________
Draw a simple sketch of the object (Label any lights, colors, protrusions)
(On a separate piece of paper, please sketch a simple map of the area showing your position and the object's position.
Include an arrow denoting the direction of North. Indicate direction that the object was moving.)
Personal AccountPlease describe the incident as it happened. Be sure that your narrative includes the following. Be as detailed as possible:
- Where were you and what were you doing at the time?
- What made you first notice the object?
- What did you think the object was when you first noticed it?
- Describe your reactions and actions, during and after sighting the object.
- Describe the object and its actions.
- How did you lose sight of the object?
(Use additional pages as necessary)
Environmental Situation (Check/Fill in as Applicable)Viewed From: Outdoors( ) Indoors( ) Car( ) Aircraft( ) Boat( ) Other _________________________ Viewed Through: Glasses( ) Window( ) Screen( ) Binoculars( ) Telescope( ) Still Camera( ) Movie Camera( ) Theodolite( ) Radar( ) Other _________________________ Area/Location: City( ) Suburban( ) Rural( ) Industrial( ) Commercial( ) Residential( ) Area/Terrain: Fields( ) Woods( ) Hills( ) Mountains( ) River( ) Pond( ) Lake( ) Area/Technical: Airport( ) Powerlines( ) Power Station( ) Railroad Tracks( ) Other ____________________________ Sky Condition: Clear( ) Partly Cloudy( ) Overcast( ) Foggy( ) Heavy( ) Medium( ) Light( ) Precipitation: None( ) Rain( ) Fog( ) Sleet( ) Snow( ) Heavy( ) Medium( ) Light( ) UFO Direction: First Seen in the __________ / Last Seen in the ___________ It Moved from __________ to ____________ UFO Elevation: First Seen 1/4( ) 1/2( ) 3/4( ) of the way up horizon Overhead( ) Other_________________ Last Seen 1/4( ) 1/2( ) 3/4( ) of the way up horizon Overhead( ) Other_________________ UFO Distance: When Closest to me ___________ (feet/meters) UFO Altitude when closest to the ground ____________ (feet/meters) UFO Passed: In Front of ____________, which was ____________ in distance from the witness. Behind __________________, which was ____________ in distance from the witness. Also in the Area: Airplane( ) Helicopter( ) Balloon( ) Searchlight( ) Other ____________________ Before witness sighted UFO( ) During UFO sighting( ) After UFO sighting( )
Object Description(Check/Fill in as applicable)Observed: An Object( ) Number of _____ Shape of ______ Color(s)______ A Light( ) Number of _____ Shape of ______ Color(s) _______ Describe: Sound: _____________________________________________ Smell: _____________________________________________ Speed: _____________________________________________ Real Size: Larger( ) Smaller( ) Same Size( ) as the object listed below: Basketball( ) Compact Car( ) Standard Car ( ) House( ) Other ____________________ Apparent Size: How many times Larger( ) Smaller( ) if put in the sky beside object below? __________ Times the size of a star __________ Times the size of a full moon Bright as: A Star( ) The Moon( ) Or a _______________ light if placed at the same distance away. Did the Object(s) or Light(s): (Please elaborate on items checked below on a separate sheet.) Change Direction?( ) Hover?( ) Affect Radio/TV?( ) Turn Abruptly?( ) Descend?( ) Affect Electricity?( ) Fall like a leaf?( ) Ascend?( ) Affect Magnetism?( ) Absorb objects?( ) Over Powerlines?( ) Affect Timepiece?( ) Eject objects?( ) Over a building?( ) Affect Engine?( ) Change Shape?( ) Land on ground?( ) Affect vehicle?( ) Cast Shadow?( ) Land in water?( ) Affect animal?( ) Cast Light?( ) Carry occupants?( ) Affect human?( ) Reflect Light?( ) Communicate?( ) Affect water?( ) Leave a trail?( ) Give off heat?( ) Affect ground?( ) Disintegrate?( ) Leave Residue?( ) Affect Vegitation?( ) Flutter?( ) Spin?( ) Blink?( ) Pulsate?( ) Appear Solid?( ) Have fuzzy edges?( ) Have outline?( ) Wobble?( ) Vibrate?( ) Glow?( ) Appear Transparent?( )
How many other witnesses? ___________________ Did any other Agency Contact You? ___________ Please provide the Names/Addresses/Phone Numbers of other witnesses and/or investigators or agencies on a separate sheet if applicable and known.
Signature of Observer ____________________________ You may( ) may not( ) use my name Date this form signed _______________________ Day Month Year
(To be filled out by assigned New England UFO Research Organization Investigator)NAME OF INVESTIGATOR: __________________________________________________ STREET ADDRESS: ________________________________________________________ TOWN/CITY: ____________________ STATE: ______ ZIP CODE: __________ COUNTRY: _______________________ CASE NUMBER: _______________________