SUBJECT: ABDUCTEE QUESTIONARE FILE: UFO632 Please send the completed questionnaire with the correct postageto: 1. Your age? ( )under 30, ( )30©40, ( )over 40 2. Your sex? ( )male, ( )female 3. Do you consider yourself an abductee or contactee? Briefly describe why on Ô question #3. ( )abductee, ( )contactee, ( )neither 4. Have you had any problems: a. securing or holding a job? ( )most, ( )some, ( )none b. with relationships? ( )most, ( )some, ( )none c. with your mental, physical, or emotional health? ( )most, ( )some, ( )none If you would like to attach a more detailed answer to question #4, please do so on a separate sheet of paper. 5. Have you experienced: a. a single contact or visitation ( )most, ( )some, ( )none b. multiple contacts or visitations ( )most, ( )some, ( )none 6. Have you had multiple contacts or visitations: a. since childhood? ( )most, ( )some, ( )none b. as an adult only? ( )most, ( )some, ( )none 7. Have you experienced: a. a single UFO sighting? ( )most, ( )some, ( )none b. multiple UFO sightings? ( )most, ( )some, ( )none c. distant UFO sightings? ( )most, ( )some, ( )none d. close UFO encounters? ( )most, ( )some, ( )none e. witnessing UFO landing(s)? ( )most, ( )some, ( )none f. contact with "beings"? ( )most, ( )some, ( )none Should you wish to provide a more detailed answer to any part of question #7, please do so on a separate sheet of paper, referencing which part(s) your answer pertains to. 8. Do you regard occupants of UFO's as being "alien" to you? ( )most, ( )some, ( )none Please elaborate on this, and describe their physical characteristics on a separate sheet of paper, referencing question #8. 9. Do you know the specific names of any of the "beings" you may have had contact ( )most, ( )some, ( )none with? Describe more fully on a separate sheet of paper, referencing question #9. 10. Do you suspect something may have been implanted in your physical body by the "beings?" ( )most, ( )some, ( )none If you answered "most" or "some", please elaborate on a separate sheet of paper, Ô 11. Have you had any episodes of missing or unaccounted time in association with one or more of your UFO experiences? ( )most, ( )some, ( )none Please elaborate on a separate sheet of paper, referencing question #11. 12. Have you been living consistently with a parent, husband or wife, close relative, friend, or other support figure in a dependent situation? ( )most, ( )some, ( )none If you answered "most" or "some" please indicate with which and for how long on a separate sheet of paper, referencing question #12. 13. Have you had or do you continue to have a limited capability for responsibility and/or independence? ( )most, ( )some, ( )none 14. Have you had a history of constant or periodic nomadic life©style? ( )most, ( )some, ( )none Please feel free to elaborate on a separate sheet of paper, referencing question #14. 15. Please describe your marital situation: a. single? ( )most, ( )some, ( )none b. married? ( )most, ( )some, ( )none c. never married? ( )most, ( )some, ( )none d. divorced? ( )most, ( )some, ( )none 16. Do you currently have custody of your children, if any? ( )most, ( )some, ( )none If so, please elaborate on a separate sheet of paper, referencing question #16. 17. Have you experienced unexplained or seemingly irrational fears and/or anxiety attacks? ( )most, ( )some, ( )none 18. Have you had a history of psychological instability or diagnosed mental disorder, such as Schizophrenia? ( )most, ( )some, ( )none If you answered "most" or "some," please describe what type of disorder on a separate sheet of paper, referencing question #18. 19. How do you personally view the study of Unidentified Flying Objects (UFO's)? a. as a science? ( )most, ( )some, ( )noneÔ phenomenon? ( )most, ( )some, ( )none c. as an "obsession" in your life? ( )most, ( )some, ( )none d. as other? ( )most, ( )some, ( )none Please elaborate on a separate sheet of paper, referencing question #19. 20. Would you say that your abduction or contact experiences (if any) have been, for the most part: a. benevolent? ( )most, ( )some, ( )none b. traumatic? ( )most, ( )some, ( )none c. other? ( )most, ( )some, ( )none Feel free to elaborate on a separate sheet of paper, referencing question # 20. 21. Do you feel that you have been given information by the "beings?" ( )most, ( )some, ( )none Please elaborate on a separate sheet of paper, referencing question #21. 22. Do you feel that you will be abducted or contacted again? ( )most, ( )some, ( )none 23. Were there any other people involved in your abduction(s) or contact(s)? ( )most, ( )some, ( )none Please elaborate on a separate sheet of paper, and indicate the total number along with any other information you feel is relevant, referencing question #23. 24. Were there any uniformed or non©uniformed humans present during your abduction(s) or contact(s) that seemed to be assisting or working with the "beings?" ( )most, ( )some, ( )none Please elaborate on a separate sheet of paper, referencing question #24. 25. Do you remember seeing any animals, fish, mammals, or other life forms during your abduction(s) or contact(s)? ( )most, ( )some, ( )none If so please elaborate on a separate sheet of paper, referencing question #25. 26. In your family, how many people have had abduction or contact experiences? ( )most, ( )some, ( )none Please elaborate on a separate sheet of paper, referencing question #26. 27. How many of your friends have mentioned that they have had abduction or contact experience? ( )most, ( )some, ( )none Please elaborate on a separate sheet of Ô 28. Do you have any unexplained marks, cuts, scars or other physical features on your body that you can't explain? ( )most, ( )some, ( )none Please feel free to elaborate on a separate sheet of paper, referencing question #28. 29. Have the "beings" given you any artifact, physical object, present or gift that you: a. now have in your possession? ( )most, ( )some, ( )none b. have had in your possession? ( )most, ( )some, ( )none Please elaborate on a separate sheet of paper, referencing question #29. 30. Were you shown any "symbols," pictures, maps or diagrams by the "beings?" ( )most, ( )some, ( )none a. Do you have conscious memory of them? ( )most, ( )some, ( )none Please elaborate on a separate sheet of paper with drawings and sketches to the best of your ability, referencing question #30. 31. Do you remember any of the "beings" eating or drinking nourishment? ( )most, ( )some, ( )none 32. In your own analysis, has your abduction or contact experience changed your life? ( )most, ( )some, ( )none a. For the better? ( )most, ( )some, ( )none b. For the worse? ( )most, ( )some, ( )none c. Other? ( )most, ( )some, ( )none Please feel free to elaborate on a separate sheet of paper, referencing question #32. 33. Have you had "psychic" experiences, ESP experiences, or other similar experiences? ( )most, ( )some, ( )none a. Before your abduction or contact experience(s)? ( )most, ( )some, ( )none b. After your abduction or contact experience(s)? ( )most, ( )some, ( )none Please elaborate on a separate sheet of paper, referencing question #33. 34. How do you view the "beings" and how do you view your interaction with them: a. loved by them? ( )most, ( )some, ( )none b. threatened by them? ( )most, ( )some, ( )none c. indifferent towards you? ( )most, ( )some, ( )none d. other? ( )most, ( )some, ( )noneÔ paper, referencing question #34. 35. What is your profession, work status or chosen field of study currently? ____________________________________________________________________ 36. Do you feel that the "beings" have had anything to do with your choice of profession, or your field of study? ( )most, ( )some, ( )none Please elaborate on a separate sheet of paper, referencing question #36. 37. Have you had any contact with other UFO researchers, paranormal researchers, or any individuals, organizations or groups with regard to your experience(s)? ( )most, ( )some, ( )none Please list the names of individuals, organizations or groups on a separate sheet of paper, referencing question #37. 38. As the result of your experience(s), have you had any contact with: a. the military? ( )most, ( )some, ( )none b. one or more intelligence agencies? ( )most, ( )some, ( )none c. law enforcement individuals or agencies? ( )most, ( )some, ( )none d. other? ( )most, ( )some, ( )none Please elaborate on a separate sheet of paper and provide specific names if possible, referencing question #38. 39. Have you ever been cautioned or warned about talking or writing about your experience(s)? ( )most, ( )some, ( )none If so, by whom? a. the "beings?" ( )most, ( )some, ( )none b. the military? ( )most, ( )some, ( )none c. one or more intelligence agencies? ( )most, ( )some, ( )none d. law enforcement agencies? ( )most, ( )some, ( )none e. other? ( )most, ( )some, ( )none Please elaborate on a separate sheet of paper and provide specific names if possible, referencing question #39. 40. Have you ever had any contact with the "men©in©black?" ( )most, ( )some, ( )none Please elaborate on a separate sheet of paper, referencing question #40. 41. Do you think the public deserves the right to know about any and all information regarding UFO's and UFO occupants? ( )most, ( )some, ( )noneÔ 43. Do you desire hypnotic regression? ( )most, ( )some, ( )none 44. Do you fear hypnotic regression? ( )most, ( )some, ( )none 45. Have you had one or more dreams in which some aspect of the dream content is UFO©related or connected to the UFO phenomenon? ( )most, ( )some, ( )none a. one dream? ( )most, ( )some, ( )none b. multiple dreams? ( )most, ( )some, ( )none c. re©occurring dreams? ( )most, ( )some, ( )none Please share your dream content on a separate sheet of paper, referencing question #45. In addition, you are encouraged to begin a dream journal, in which you record in narrative form your dreams. There are many books on the market that can assist you in interpreting your dream content. Additionally, you may wish to take part in a dream group©©a group of people interested in working with their dream material and their unconscious. These groups are usually led by a psychologist or therapist trained in working with dreams. 46. Do you have children? If so, list their ages here____________________________________________________________ Do you suspect that your children may have had, or are currently experiencing, contact with UFO occupants and/or "beings?" ( )most, ( )some, ( )none If you have answered this question, please elaborate on a separate sheet of paper, referencing question #46. 47. Has your abduction or contact experience(s) had any effect on your religious or spiritual views? ( )most, ( )some, ( )none a. changed your religious or spiritual views a little? ( )most, ( )some, ( )none b. changed your religious or spiritual views a moderate amount? ( )most, ( )some, ( )none c. changed your religious or spiritual views a lot? ( )most, ( )some, ( )none d. your views remain relatively unchanged? ( )most, ( )some, ( )none Please feel free to elaborate on any part of the question on a separate sheet ofÔ 48. Did this questionnaire: a. threaten you? ( )most, ( )some, ( )none b. comfort you? ( )most, ( )some, ( )none c. produce feelings of indifference or ambivalence in you? ( )most, ( )some, ( )none d. other? ( )most, ( )some, ( )none Please feel free to elaborate on this question #48, on a separate sheet of paper. 49. As a final question, please attach on a separate sheet of paper a narrativeof what you feel you may have experienced, and what you have conscious memory of. Often when a person writes out on paper a conscious recollection of some part oraspect of their life, their memory is triggered and more detail is obtained. Please include all the "little" details or "seemingly insignificant" details, aswell as your insights, or intuitions. Also, please feel free to write about anysubject that you feel is important and pertinent to this questionnaire. I, the undersigned, do hereby certify that I have answered all questions in thisquestionnaire truthfully and to the best of my ability. ___________________________________________ ________________________________ (Signature of contributor of information) (Date) ___________________________________________ ________________________________ (Please print your name) (Area code and phone number) _______________________________________________________________________________ (Print your street address or post office box number, city, state, and zip code) _____________Please check here if you would like to be kept informed about theresults of this questionnaire. Please enclose a S.A.S.E with $.52 postage toinsure a response. P.S...I can be reached at my daytime phone number, which is 402©421©1701. Icannot return your call at my expense, but I will be happy to return your callcollect. Thanks, SHC. ********************************************** * THE U.F.O. 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