Exploration Research UFO Reporting Form

This form is designed for recording basic facts regarding UFO sightings,
contact or abduction experiences.  We encourage you to share as much
information as possible, however, please fill in this form as completely
as possible.  Any additional information or comments should be noted at
the bottom of this form, on the back or on another piece of paper.

Date of sighting or experience ___/___/___

Time FROM ___________  am / pm  TO ___________  am / pm

Please categorize your experience (Check all that apply):

___ Night Sighting  (Lights in the sky)

___ Daylight Sighting  (Unrecognized or Unidentified Object)

___ Object on the ground   ___ Object in flight

If object moved on the ground or in the air, please describe motion:

________________________________________________________________________

Please describe the object as completely as possible:








___ Unrecognized life form witnessed

___ Contact with unrecognized life form(s).  Please describe contact:

________________________________________________________________________

Please describe as accurately as possible the life form(s).  Include a
description of head, arms, hands, torso, hair & skin color & texture.
Also, describe clothing and any equipment.  Use back of form if necessary.











___ Unexplained loss of time   ___ Positive recall of abduction experience

If abduction experience is positively recalled, please describe the
exact circumstances and your experience as completely as possible.  Use
the back of this form or another piece of paper.

Did you experience any psychological or physiological effects? _______
Please describe:







___ Photographs taken    ___ Home Video shot

Please give the location where this occurred as exactly as possible:

_________________________________________________________________________

_________________________________________________________________________




Would you be available for an Exploration Research staff member to contact

you regarding your experience?  _______  Daytime phone (____) ____-_______

Name:_____________________

As completely as possible, please describe exactly what happened.  Use
this space, the back of this form and another piece of paper if necessary.
If it is more convenient, we encourage you to record on audio cassette your
experience.  The top portion of this form should still be filled out and
mailed along with your tape.  If possible, please include a drawing of what
you saw.




































When complete, mail this form to: Exploration Research
                                  Data Collection Dept
                                  P.O. Box 4756
                                  Scottsdale, Arizona  85261-4756
