o o oo I ~DWJiR! QOI'StiOHNAIRE 1. When did rou see the ob3eota 1.1 Datet t,'fl II iJ 1.2 !We ot Dqa (Circle One) I'? '3 ~ 1.3 tiM Zones (Circle One)t (8:\ Eastern Y. Central c. Uountain (Circle One)! d. Pacific Dqlight Saving 1 . 4 Circle one ot the following to indicate how certain you are or JOUr answer to the above question 1.21 ~ Certain"W~,~'4 c. Not very sure Y. Fairly certain d. Just a guess ,.:.: t. tlhere wre you when JOU saw the objectr POs81 Address Additional Remarks 1 lmen 10\1 saw the objectr (Circle One)t a. Inside a buUdina d. In an airplane b. In a car e. At sea c. Outdoors 3.1 Were JO\U (Circle One)t In the buoiness section ot a citJ? In the recidential section ot a city? In open eountr.ys!de? Flying near an a1 rtl.eld? e. ny1na over a c~. ty? t. Flyin1 over open country? 5. When did JOU official that rou had seen the object? 6. llhat were you doing at the time you saw the object? 6.1 What had you been doing for the 30 minutes before you saw the object? T.ey to list the activity or activities and the approximate aDl\lunt ot time spent on each. 7. Were JOG moving at any time while YOQ saw the object? (Circle One) 1 IF you answered YES, then complete the following questionst 1.1 What direction ,.78re you movinc? (Circle One) 1 a. North b. !Tortheast f. Southwest d. Southeast h. llorthwest 7. 2 How fast ~re you moving? miles per hour. 7. 3 Did you atop at any time while ,ou t-Jere loold.ng at the object? (Circle One): Yes or 8, What direction were you looking \/hen you first saw the object? (Circle One) 1 a. North b. lbrtheast d. Southeast h. Northwest 8.1 What direction ttere JOU 1oold.na when the object c:l1aappeared? Cire1e One) 1 a. North b. Northeast d. Soutbeaet 8.2 Circle one of the following to indicate how certain you are ot to the above question and preoedina question ( 8 and ~ FairlJ certain c. Not veey wre d, Just a guess 9. Were JOU wearina e;ye glasses when ,ou aaw the object? (Circle One)l 10. How was the object seen? (Circle One)r Through window class b. Through 111ndsb1eld o. Through binoculars d. Through teleaoope Through theodolite Through sunglasses Through open apace What do 7011 remember about the weather condi tiona at the time you saw the 11.1 CLOOm (Circle One) a. Clear ak7 b. lias)" . {c.) Scattered clouds Y.' Thick or heavy clouds e. Don't remember 11. 2 WIND (Circle One) Slight breeze Strong wind Don t remember 11.3 WEATHER (Circle One) Fog, Mist, or light rain c. Moderate or heaV)" rain e. Don't remember 11.4 TEMPERA'l'URE (Circle One) (.,!.J Cool e Don t remember 12. Estilftate how long ,ou saw the object? Hours I a 1-Ifiiltes Secoiids 12.1 Circle one or the following to indicate how certain )'OU are of your flO Question 12t a. Certain b. Fairly sure 13. Did the object lookt (Circle One) Solid 14 Did the object at &n7 timet Not very sure Just a guess (Circle One tor each question) Cbanp direction? -;.., Chanp apeed? Cbanp size? Change color? Break up into parts or Oive orr smoke? Change brightness? Flicker, throb, or Don't know I>Onlt kiiow bOnlt know Remain motionless? 15. Did the. object give off a light? (Circle One)t lS .1 D' JOU answered Y!S, llhat was the color ot the light? 16. Tell in a tew Wlrds the following things about the object? IF there was !-lORE THAN ONE object, then how maey were there? 1'ter: 5't;.., d-llf!_jl.-t,.. Draw a picture ot how they were arranged and put an arrow to show e 1/ ------ direction they lfftr& traveling. 3, 18. Did the object at any tirtle t 18.1 ~ve behind aOJilething? (Circle One) Ye s tfo ~on IF you anslred lts, then tell torhat it 1110ved behind. 18.t MoYe in front or eomethine? (Circle One) Yea D' JOil anavared IES, then tell \Nt it mJTed in front or. 18.3 Blend with the backcround? (Cit"Cle One) of the following objects is rou aaw? (Circle One)t b. Baseball o. Basketball (d.) Dic70le wheel Y. Ottice deek about the same actual size as the object f. Au toJilobile I Small airplane h. Large airplaM 1. Dirigible 19.1 Circl;e one or the following to indicate how certain you are or your answer to Qu.estion 19. a. Certain b. Fairly certAin c. Not very sure @Uncertain 20. Try to tell the following things about the object: How high above the earth was it? ~I"* " ~ f'eet. How tar was it from ;you? (1/i 1 Dli~ l'eet or _ miles. How fast waa it going? '3~ lJ miles per hOur. Circle one or the rouoWingto inCHoate how certain you are or your anst-Jer f.O the above queationsr a. Certain b. Fairly certain 21. RoN did the object disappear from viM d. Don't _r_em_em.....,b_e_r SECTIOif D 22. In th~ f'ol~Ol'dng sketch, irnag1ne your eye at the point shol-m. Place an "A" on the curved line to show b:ltf high the object 1rc1s above the horl.zon (skyline) when you first sal'r it. Place a "B" to show there it lras 'rhen 10\1 last saw 1 t. Ove ead t3. In the foUcnetna sketch place an "A" at the position the object l-ras when tint en it, and a "B" at ita position 14\en JOU last saw it 24. Draw a picture that wUl show the motion that the object made. Plaoe an at the belinnina or ita path and a "B" at the end or ita path. 2S. Draw a picture that will show the shape or the object. Label and include in your sketch &IJ1' details of the object that JOU saw and place an arrow beside the dra1d.ng to show the direction the object was moving SECTI'lll E 26. l1aa \his the first tir,te that you have seen an object like this? 26.1 IF 70\l answered NO, then when, where, and under what eondi tiona dld 27. In your opinion what do you think the object was and what might have caused 28. Give the following info~ation about What ia )'OUr present job? ----' 29. l'laa aJl10M else with you at the tiJne you saw the object? (Circle One)t Yes or 29.1 IF f0\1 ariswered YFS, did they see the object too? (Circle One) r Yea or ~ro 29.2 Please list their names and addreaseat Mida1 e tfame Pl add here 1"7 tu.rtber UM add1 t.ional aht. of the ta which JOU believe are iq)ortant. liM eise paper, it necesaa.J7.