FORM: UFORC 80-17 #02192007


uforc_80-17  

SIGHTING OF UNIDENTIFIED PHENOMENA QUESTIONNAIRE
UFORC INTERNATIONAL 
GLOBAL NETWORK

THIS QUESTIONNAIRE HAS BEEN PREPARED SO THAT YOU CAN GIVE UFORC.com AS MUCH INFORMATION AS POSSIBLE CONCERNING THE UNIDENTIFIED PHENOMENON THAT YOU HAVE OBSERVED. PLEASE TRY TO ANSWER ALL OF THE QUESTIONS. THE INFORMATION YOU GIVE WILL BE USED FOR RESEARCH PURPOSES. YOUR NAME WILL NOT BE USED IN CONNECTION WITH ANY OF YOUR STATEMENTS OR CONCLUSIONS WITHOUT YOUR PERMISSION. RETURN TO UFO RESEARCH CENTER, FOR FORWARDING TO ADVISORY PANEL SEND ATTENTION TO C. MONTGOMERY, 1402 LAKE TAPPS PKWY EAST, SUITE 104 PMB 265, SEATTLE WASHINGTON USA 98092-8157 (IF ADDITIONAL SHEETS ARE NEEDED FOR NARRATIVE OR SKETCHES ATTACH SECURELY TO THIS FORM OR ANNOTATE WITH YOUR NAME FOR IDENTIFICATION.)
 
1. WHEN DID YOU SEE THE PHENOMENON?
  		DAY ______ MONTH ______ YEAR ______
2. WHAT TIME DID YOU FIRST SIGHT THE PHENOMENON?
  		HOUR ______ MINUTES ______ [ ] A.M. [ ] P.M.
3. WHAT TIME DID YOU LAST SIGHT THE PHENOMENON?
  		HOUR ______ MINUTES ______ [ ] A.M. [ ] P.M.
4. TIME/ZONE [ ] DAYLIGHT SAVINGS [ ] STANDARD
 
  [ ]EASTERN [ ]CENTRAL [ ]MOUNTAIN [ ]PACIFIC [ ]OTHER
5. WHERE WERE YOU WHEN YOU SAW THE PHENOMENON? IF IN CITY GIVE THE NEAREST STREET ADDRESS AND INDICATE ON A HAND DRAWN MAP WHERE YOU WERE STANDING WITH REFERENCE TO THE ADDRESS. IF IN THE COUNTRY, IDENTIFY THE HIGHWAY YOU WERE ON OR NEAR AND TRY TO FIX A DISTANCE AND DIRECTION FROM SOME RECOGNIZABLE LANDMARK.
 
 
 
 
 
 
 
 
6. IMAGINE YOU ARE AT THE POINT SHOWN IN THE SKETCH. PLACE AN "A" ON THE CURVED LINE TO SHOW HOW HIGH THE PHENOMENON WAS ABOVE THE HORIZON, OR SKYLINE, WHEN FIRST SEEN. PLACE A "B" ON THE SAME CURVED LINE TO SHOW HOW HIGH ABOVE THE HORIZON THE PHENOMENON WAS WHEN LAST SEEN.

 
 

 

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6A. NOW IMAGINE YOU ARE AT THE CENTER OF THE COMPASS ROSE. PLACE AN "A" ON THE COMPASS TO INDICATE THE DIRECTION TO THE PHENOMENON WHEN FIRST SEEN. PLACE A "B" ON THE COMPASS TO INDICATE THE DIRECTION TO THE PHENOMENON WHEN LAST SEEN.
 
 
 
 
7. IN THE SKETCH BELOW, PLACE AN "A" AT THE POSITION OF THE PHENOMENON WHEN FIRST SEEN, AND A "B" AT THE POSITION OF THE PHENOMENON WHEN LAST SEEN. CONNECT THE "A" AND "B" WITH A LINE TO APPROXIMATE THE MOVEMENT OF THE PHENOMENON BETWEEN "A" AND "B". THAT IS, SCHEMATICALLY SHOW WHETHER THE MOVEMENT APPEARED TO BE STRAIGHT, CURVED OR ZIG-ZAG. REFER TO SMALLER SKETCH AS AN EXAMPLE OF HOW TO COMPLETE THE LARGER SKETCH.
 
 
 
 
 

 
 

 

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8. WHERE WERE YOU WHEN YOU SAW THE PHENOMENON? (Check appropriate blocks)
  OUTDOORS   IN BUSINESS SECTION OF CITY
  IN BUILDING   IN RESIDENTIAL SECTION OF CITY
  IN CAR           [ ]AS DRIVER    [ ]AS PASSENGER   IN OPEN COUNTRYSIDE
  IN BOAT   NEAR AIRFIELD
  IN AIRPLANE    [ ]AS PILOT    [ ]AS PASSENGER   FLYING OVER CITY
  OTHER   FLYING OVER OPEN COUNTRY
  OTHER
A. IF YOU WERE IN A VEHICLE, COMPLETE THE FOLLOWING:
WHAT DIRECTION WERE YOU MOVING? HOW FAST WERE YOU MOVING?
  NORTH   EAST
  SOUTH   WEST DID YOU STOP ANYTIME WHILE OBSERVING THE PHENOMENON?

[ ]YES    [ ]NO
  NORTHEAST   SOUTHEAST
  NORTHWEST   SOUTHWEST
EXPLAIN WHETHER SUCH MOVEMENT AFFECTS YOUR SKETCHES IN ITEMS 5 AND 6.
 
 
DESCRIBE TYPE OF VEHICLE YOU WERE IN AND TYPE OF ROAD, TERRAIN OR BODY OF WATER YOU TRAVERSED DURING THE SIGHTING. STATE WHETHER WINDOWS OR CONVERTIBLE TOP WERE UP OR DOWN.
 
 
HOW MUCH OTHER TRAFFIC WAS THERE?
 
 
DID YOU NOTICE ANY AIRPLANES?  [ ]YES  [ ]NO. IF "YES," DESCRIBE WHEN THEY WERE IN SIGHT RELATIVE TO THE TIME OF SIGHTING OF THE PHENOMENON AND WHERE THEY WERE IN THE SKY RELATIVE TO THE POSITION OF THE PHENOMENON.
 
 
 
A. HOW LONG WAS THE PHENOMENON IN SIGHT?
LENGTH OF TIME   CERTAIN OF TIME   NOT VERY SURE
  FAIRLY CERTAIN   JUST A GUESS
HOW WAS TIME DETERMINED?
 
 
WAS THE PHENOMENON IN SIGHT CONTINUOUSLY?  [ ]YES   [ ]NO. IF "NO," INDICATE WHETHER THIS IS DUE TO YOUR MOVEMENT OR THE BEHAVIOR OF THE PHENOMENON, AND DESCRIBE SUCH MOVEMENT OR BEHAVIOR. INDICATE DISAPPEARANCES ON PREVIOUS SKETCHES.
 
 
 
 

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10. IF THERE WERE MORE THAN ONE PHENOMENON, HOW MANY WERE THERE? DRAW A PICTURE TO SHOW HOW THEY WERE ARRANGED. DID THE ARRANGEMENT CHANGE DURING THE SIGHTING?
 
 
 
 
11. CONDITIONS (Check appropriate blocks.)
A. SKY
B. WEATHER
  DAY   CUMULUS CLOUDS (Low fluffy)   FOG OR MIST
  TWILIGHT   CIRRUS CLOUDS (High fleecy or
herringbone)		   HEAVY RAIN
  NIGHT   LIGHT RAIN OR DRIZZLE
  CLEAR   NIMBUS CLOUDS (Rain)   HAIL
  PARTLY CLOUDY   CUMULONIMBUS CLOUDS
(Thunderstorms)		   SNOW OR SLEET
  COMPLETELY OVERCAST   UNKNOWN
  HAZE OR SMOG   NONE OF THE ABOVE
C.  IF THE SIGHTING WAS AT TWILIGHT OR NIGHT, WHAT DID YOU NOTICE ABOUT THE STARS AND MOON?
(1). STARS
(2) MOON
  NONE   BRIGHT MOONLIGHT   NO MOONLIGHT
  A FEW   MOON WITH HALO   UNKNOWN
  MANY   MOON HIDDEN BY CLOUDS
PARTIAL (New or quarter)
  UNKNOWN
D.  IF THE SIGHTING WAS IN DAYLIGHT, WAS THE SUN VISIBLE? [ ]YES   [ ]NO. IF "YES," WHERE WAS THE SUN AS YOU FACED THE PHENOMENON?
  IN FRONT OF YOU   TO YOUR RIGHT   OVERHEAD (Near noon)
  IN BACK OF YOU   TO YOUR LEFT   UNKNOWN
E.  SPECIFY THE MAJOR SOURCE OF ILLUMINATION PRESENT DURING THE SIGHTING, SUCH AS THE SUN, HEADLIGHTS OR STREET LAMP, ETC. FOR TERRESTRIAL ILLUMINATION, SPECIFY DISTANCE TO LIGHT SOURCE.
 
 
 
 
12.  GIVE A BRIEF DESCRIPTION OF THE PHENOMENON, INDICATING WHETHER IT APPEARED DARK OR LIGHT, WHETHER IT REFLECTED LIGHT OR WAS SELF-LUMINOUS AND WHAT COLORS YOU NOTICED. DESCRIBE YOUR IMPRESSION OF WHETHER IT WAS SOLID OR TRANSPARENT, WHETHER EDGES WERE SHARP OR FUZZY. DESCRIBE THE SHAPE OR INDICATE IF IT APPEARED AS A POINT OF LIGHT. INDICATE COMPARISONS WITH OTHER OBSERVED OBJECTS, LIKE STARS, A LIGHT OR OTHER OBJECT IN YOUR FIELD OF VIEW.
 
 
 
 
 
 

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13. DID THE PHENOMENON
YES NO UNKNOWN
MOVE IN A STRAIGHT LINE?      
STAND STILL AT ANY TIME?      
SUDDENLY SPEED UP AND RUN AWAY?      
BREAK UP IN PARTS AND EXPLODE      
CHANGE COLOR      
GIVE OFF SMOKE      
CHANGE BRIGHTNESS      
CHANGE SHAPE?      
FLASH OR FLICKER?      
DISAPPEAR AND REAPPEAR?      
SPIN LIKE A TOP?      
MAKE A NOISE?      
FLUTTER OR WOBBLE?      
14.  WHAT DREW YOUR ATTENTION TO THE PHENOMENON?
 
 
 
 
A.  HOW DID IT FINALLY DISAPPEAR?
 
 
 
 
B.  DID THE PHENOMENON MOVE BEHIND OR IN FRONT OF SOMETHING, LIKE A CLOUD, TREE, OR BUILDING AT ANY TIME?

[ ]YES   [ ]NO. IF "YES," DESCRIBE.
 
 
 
 

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15.  DRAW A PICTURE THAT WILL SHOW THE SHAPE OF THE PHENOMENON. INCLUDE AND LABEL ANY DETAILS THAT MIGHT HAVE APPEARED AS WINGS OR PROTRUSIONS, AND INDICATE EXHAUST OR VAPOR TRAILS. INDICATE BY AN ARROW THE DIRECTION THE PHENOMENON WAS MOVING.
 
 
 
 
 
 
 
 
 
 
 
 
16.  WHAT WAS THE ANGULAR SIZE? HOLD A MATCH AT ARM'S LENGTH IN FRONT OF A KNOWN OBJECT, SUCH AS A STREET LAMP OR THE MOON. NOTE HOW MUCH OF THE OBJECT IS COVERED BY THE HEAD OF THE MATCH. NOW IF YOU HAD BEEN ABLE TO PERFORM THIS EXPERIMENT AT THE TIME OF THE SIGHTING, ESTIMATE WHAT FRACTION OF THE PHENOMENON WOULD HAVE BEEN COVERED BY THE MATCH HEAD.
 
 
 
 
 
 
 
 
 
 
 
 

 

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(C1)  
17.  DID YOU OBSERVE THE PHENOMENON THROUGH ANY OF THE FOLLOWING? INCLUDE INFORMATION ON MODEL, TYPE, FILTER,LENS PRESCRIPTION OR OTHER APPLICABLE DATA.
  EYEGLASSES   CAMERA VIEWER
  SUNGLASSES   BINOCULARS
  WINDSHIELD   TELESCOPE
  SIDE WINDOW OF VEHICLE   THEODOLITE
  WINDOWPANE   OTHER
A. DO YOU ORDINARILY WEAR GLASSES? [ ]YES  [ ]NO B. DO YOU USE READING GLASSES [ ]YES  [ ]NO
18. WHAT WAS YOUR IMPRESSION OF THE SPEED OF THE PHENOMENON?
GIVE ESTIMATE OF SPEED ____________ 		19. WHAT WAS YOUR IMPRESSION OF THE DISTANCE OF THE PHENOMENON?
GIVE ESTIMATE OF DISTANCE ____________
20.  IN ORDER THAT WE MAY OBTAIN AS CLEAR A PICTURE AS POSSIBLE OF WHAT YOU SAW, DESCRIBE IN YOUR OWN WORDS A COMMON OBJECT OR OBJECTS WHICH, WHEN PLACED IN THE SKY, SIMILAR TO WHERE YOU NOTED THE PHENOMENON, WOULD BEAR SOME RESEMBLANCE TO WHAT YOU SAW. DESCRIBE SIMILARITIES AND DIFFERENCES BETWEEN THE COMMON OBJECT AND WHAT YOU SAW.
 
 
 
 
21.  DID YOU NOTICE ANY ODER, NOISE, OR HEAT EMANATING FROM THE PHENOMENON OR ANY EFFECT ON YOURSELF, ANIMALS OR MACHINERY IN THE VICINITY? [ ]YES  [ ]NO. IF "YES," DESCRIBE.
 
 
 
 
A.  DID THE PHENOMENON DISTURB THE GROUND OR LEAVE ANY PHYSICAL EVIDENCE? [ ]YES  [ ]NO. IF "YES," DESCRIBE.
 
 
 
 
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(C1)  
22.  HAVE YOU EVER SEEN THIS OR A SIMILAR PHENOMENON BEFORE? [ ]YES   [ ]NO. IF "YES," GIVE DATE AND LOCATION.
 
 
 
23.  WAS ANYONE WITH YOU AT THE TIME YOU SAW THE PHENOMENON? [ ]YES   [ ]NO.
IF "YES," DID THEY SEE IT TOO? [ ]YES   [ ]NO.
A.  LIST THEIR NAMES AND ADDRESSES.
 
 
 
24. GIVE THE FOLLOWING INFORMATION ABOUT YOURSELF
LAST NAME, FIRST NAME, MIDDLE NAME
 
 
ADDRESS (Street, City, State and Zip Code)
 
 
TELEPHONE (Area code and number)
  		AGE
 		   MALE   FEMALE
INDICATE ADDITIONAL INFORMATION INCLUDING OCCUPATION AND ANY EXPERIENCE WHICH MAY BE PERTINENT
 
 
 
 
25. WHEN AND TO WHOM DID YOU REPORT THAT YOU HAD SIGHTED THIS PHENOMENON?

NAME ____________________ DAY _______ MONTH _______ YEAR _____
26. DATE YOU COMPLETED THIS QUESTIONNAIRE

            DAY _______ MONTH _______ YEAR _____
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(C1)  
27.  INFORMATION WHICH YOU FEEL IS PERTINENT BUT WHICH IS NOT ADEQUATELY COVERED IN THIS QUESTIONNAIRE. ALTERNATIVELY PROVIDE A NARRATIVE EXPLANATION OF THE SIGHTING.
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 


END UFORC 80-17 #02220007;



Please note: Portions of UFORC 80-17 that reference "AFR 80-17" have been omitted UFORC 80-17 Special thanks to NCAS http://www.ncas.org/condon/text/appndx-b.htm#afr8017 for use of this document. See Condon University Notice http://www.uforc.com/