l. DATE T IME G~OUP 10. CONCLUiiON 4. NUMrU!R OF OS J ECTS s. LENGTH 01' OBS2RVATION DIW!fl SUMMARY A ND AH,.L YSIS TYPE OF oas:RVATION 7. COU RSE PHYSICAL EVID!HC! 8 . I F you sow the o bject a t N IGHT, TWILIGHT, o r DAWN, who t did y o u n o tice conc e rning the STARS and MOON? 8. 1 STARS (C ~rclc One): 8.2 MOON ( Circle One): a. Br ig ht moonl ight b. A f e w b. Dull moonlight c . No moon I ig h t -pitc h d a rk d. Do n't remembe r d . Don't rcm!!mber 9. Was the object brighter than the b ackground o f the sky? ( C irc/c One): a. Yes c. Don't remembe r 10. IF it was BRIGHTER T HAN the sky background, was the brightne5s like that o f a n automobile lu:odlight ? : (Circle One ) o. A mile or more away (a distant cor)? b. Soveral blocks owoy? c . A block away? Severa I yards away? Did tJ-.~ object: (Circle One for each quest io n) a. Appear t o stand sti II a t any time? Don't Know Suddenly speed up and rush awa y atony t ime? @g) Don't Know Break up into ports or explode? Don't l(now d. Give off smoke? Don't Know e. Changa brightness? Don't Know f. Chang e shape? (~) D on't Know F Iicker, throb, or pulsate? Don't Know 1'?. Did the object move behind something at anytime, particularly a cloud? (Circle One): Yes @ Don't Know. IF you answered YES, then tell what it moved behind: _ --- 13. Did the object move in front o f something a t anytime, particularly a cloud? (Circle One): Yes Don't Know. IF y o u answered YES, than tell wha t it moved in front of: _ ----- Did the object appear : (Circle One): T ransporent? Do n't Know. Did you obsurve th e object through any of the following? Eyeglasses Yes Binoculars Sun glasses Yes Telescope Yes Windshield Theodol ite Yes NoJ Window glass Yes h . Othttr 16. Tell in a few words the following th ings about the object. 17. Dra w o picture that will show the shape of th e object or objects. Lobel ond include in your sketch any details object that you sow such as wings, protrusions, etc., and especially exhaust trails or vapor trails. Place on arrow beside th e drawing to show the direction the object wos moving. 18. The edges of the object were: (Circle One): o. Fuzzy or blurred b. like a bright star @ Sharply out I ined d. Don't remember 19. IF th~re wos MORE THAN ONE object, then how many were there? Draw o picture of how th~y were arranged, and put on arrow to show t he direction that th.,y were traveling. 20 . Draw a picture th'l t will show the moti o n tl1ot t he object or objects mode. Plac e o n "A at the l~coinning of the path, a "B ot the end of the pa th, and s how any c ha nge s in direct io n d uring tho course. 21. IF POSSIBLE, try to guess or estimate what the real size of the objec t was in it s longe s t dimensio n . ;n. How forge did the object Of objects appear as c o mpared w i th one of the following objects l1elcl in the hone/ 1 ond at about arm's length? (Circle One): Head of a pin Silv e r do ll a r Grapefruit Bas ketball Quarter k. Othe r Half dollar (Circle One of the following to indicate how certain you ore of your answer to Q uestion 2 2. a. Certain c. Not very sure ~ Fairly c ertain d. Uncertain 2 3. Ho w did the object or objects disappear from view? 2J1. In order that you can give as dear a picture as possible of what you saw, we would like for yo u to imagine that you could construct the objct that you saw. O f what type material would you make it? Ho w large would it be, a nd wha t shape wauiJ it hove? Ooscribe in your own words o common object or objects whic h when placed up i n the ~ky would give the some appearance as the object which you saw. 25. Where were you located when yo u sow the object? (Circle One): 26. Were yo u (Circle One) 27. What were you doing o t the time you saw the object, and how did you happen to notice it? 8. IF you were MOVING IN AN AUTOMOBILE or other vehicle at the tim!P, then c o mp l3te the following q ue'>tions: 28.1 What direction were you moving? (Circle One) a. North c. Eo:ot o. South g. Vlest (b) No rtheast d. South~ast f. Southwest h. No r thwest 28.2 How fast were you moving? .32 5' )t:. J:.A. :,;. 28.3 Did you stop at any time while you were looking at the obj~ct? (Circle One) Yes t,NO) What direction were you looking when you first saw the object? (Circla One) a. North c. East e. South g. West Northea~t d. Southeast f. Southw~tst h. Northwest 30. What direction were you loolcing when you l:ut saw the object? (Circle One) o. North c. East <E) Nort~ast d. Southeast f. Southwet h. Northw!ut 31. If you ora familim with beori,g t"rms (on!Julor direction), try to estimate t he nurnber o f d.,grl)u the objl)ct \iOJ I fr om true North ond ui:Jo the number of d,grees It was upward from tha horiton (cltvaticn). 1 31.1 When it first app&ar~d: o. From true North 0 7 0 d~grs~1. 31.2 When it di~appf'Ored: a. Frorn tru~ NNth .):;;._.'_., degrees. b. From horizon ., ' d.,grees. 32. In the following sketch, irnogine that you oro at the point .. hown. Place o n A" on the c urve d li n to !.how how high the object was above the hori-zon (~kyline) whn you f i rs t sow it. Place a "B" o n th!! s ome curve d line t o show how high the object was above the horizon (skyline) wh~n you los t :.ow it. 33. In the following larger sketch place o n "A" at t he position the object was when you firs t sow it, and a "(3" at its pos ition when you last sow it. Refer to small e r sketc h a s on example of how to comple t e the larger ske!tch. \~hot we re the \ 1 Iter cunditiun \ ol the timo you sow tho object? 34.1 C LOUDS (C irclo One) (2) Clc-or s~ y c. Sc o , t,roJ c loulls d. Thtc k O lteovy claude; e . Don't r ~..:mb~r 3 1. 3 WEAT. kr~ ((rrc/e One) b. F 091 IT' is t or I i g!. t r o in c. tJ.oderote ur heavy rain e. Don't rern~mber 34.2 WIND ( C irclo One) o . No w ind b. Sl inht bree2e c . Stronn wind d. Do n't rernember 34.4 T E:MPERATUi~E (C ircloJ One) tt. Don't re m.,mber 35. Wh"n did you r..:port to s ome o fficial that you hod seen thct object? Wa s an)one c l'ie with you o t the time you soH the obj.:!c t? (Circle Ont:!) yij) 36.1 IF y ou answ red YES, di-l rhcy sec th..: object h .. o? (C irclo One) \!..::;.~ No 36.2 P lease list lhe ir nom~s a nd addresses: 3/. Was this tl-la Fir~t t ime that you hod s e e n an object or objects like this? (C irclc One) (Y;;) 37.1 IF you answered NO, t h m who3n, where, a nd under what circumstancos d id y o u see other o nes? 38. l11 yu~r opinion Hha t do you t hink the objt:ct was and what might hove caused it? 39. Do yo u think you con cstim~te the speed of the object? (Circle One) Yes IF yCJu answered YES, t he n what spe~d would yo u e s ti mJte? 40. Do you think you con esti mate how for away fr om yo u the object was? (Circle One) Yes (.No IF you a ns wered YES, then how for away wo uld yo u soy it wa'i? -11. Ploa5e give t he following information about yourself: Fln.t Nome T ELEPHONE NUMBER----------- Middle Nome 7one S t a te What is your pres~nt job? Ploose indicate a ny special educati onal training that you hove hod. T echnic o l !>chool f. Other special tra inin!J d. Post graduate '12. Dote you completed this q ue s t ionnaire: di:JC :mtinued. f. .. \ l l:>on :::>o~si~ility C =:nd cbJt!C ~ 3 CO\U"!Je U.l u:l~ ~o.l:lc!.J.u ,ri ;:.h. ,fUd:J .llu4'1;. 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