N.B. This information will not be published or used in any way without previous permission.
Name: (Capital Letters Please)
Telephone Number: Occupation:
Please use a separate sheet of paper if there is insufficient room for any reply.
Describe what you saw and/or felt:
When did you (last) see the ghost? (date and time):
Were you alone at the time? (give names and addresses of anyone else present):
Where exactly did you see the ghost? (As exact as possible please)
How far away from you was the figure?
Have you heard of a ghost being seen before your experience (If so give names and addresses of anyone who told you about the ghost)
Do you know anyone who claims to have seen the ghost on a different occasion?
Did you feel anything or have a sensation of being touched? If ‘Yes’, describe as fully as you can:
Were you asleep or nearly asleep just before the experience? If so, what woke you up?
How long did the ghost remain?
What was the lighting at the time?
Was there a mirror anywhere near and where was the nearest window?
Did the form you saw seem to be aware of your presence?
Did you have an animal with you at the time? If so, did it show any reaction?
Did you recognize the ghost? If so, was that person much in your thoughts lately?
Did the form appear gradually or suddenly?
Do you have good eyesight?
Had you been drinking?
Did you have a headache or were you feeling unwell?
Did any sound accompany the sighting?
Did the figure appear to be solid or transparent?
Was the appearance in colour or black and white?
Did the figure appear and act naturally? (e.g. through an open door) Or did it appear suddenly and inexplicably?
Can you describe the figure? (e.g. a tall man wearing a cape)
For how long did you see the figure?
How did it disappear?
Did you attempt to speak to the figure?
Did the figure speak to you or appear to try to do so?
If it did speak, what did it say?
What clothing was the figure wearing?
What was your immediate reaction when you saw the figure?
How did you feel when you saw the figure? (e.g. frightened, sad, unmoved, etc)
Did you notice any variation in the temperature:
a) before you saw the figure?
b) when the figure was present?
c) after the figure had disappeared?
Had you had a long journey or were you very fatigued just before the experience?
Did you notice anything else unusual at the time? (e.g. any sound, a breeze, unusual quiet, etc)
Is the building or place where this happened reputed to be haunted?
To whom did you first report your experience?
How soon after the event?
What was his or her reaction?
Have you had any previous experiences of this kind? If so when and where?
Have you had any kind of psychic experience before?
How did you feel immediately after the experience?
Did you feel a difference in the atmosphere afterwards? (e.g. warmer, lighter, darker, colder, etc)
Would you like to have the same experience again?
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