GRI Form - Activity Report

Details of activity report form
This form gives you the opportunity to provide additional details about your experience. Please provide as many details as possible in the spaces provided.

Full Name	*
Location City/State/Country	*
Your Email Address	*
Phone Number	*
Your Age	*
How long have resided at the location?	*
Number of Occupants	*
Age of Occupants
Please indicate any problems at the site		Possible Electrical Possible Plumbing Possible Structural
Please provide any known site history
Do you have pets?	*	Yes No
Do they react strangely?	*	Yes No
Is the activity related to a particular occupant? If so list name, age, sex and relationship to you.	*
Any interest or experimentation with the paranormal? eg Ouija board use etc.	*
What is being experienced		Noises Voices Orbs Objects moving Odours Shadows Apparitions Cold / Hot Spots Other Problems with Electrical Equipment
Any connection with		Recent renovations Recent death Anniversary of death Anniversary of an event
Number of witnesses?	*
How often does activity occur?
Please describe in your own words what is happening	*
Please attach a photograph or plan of the site, activity or yourself	*
Comments on attached image
What do you believe the activity to be?
How does the activity make you feel	*	Uncomfortable Fear Anger Hatred Happiness Sadness Depression Curiosity
Do you consent to an investigation	*	Yes No
Do you consent to public release of information found during the investigation?		Yes No

If after the submission of this form, you wish to provide additional photographs you can do so by visiting the Photo Submission Page.

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