Animal Mutilation Online Reporting Form

Name (First and Last)

Mailing Address    

City        State

Phone (Optional)

Email Address

Time of Sighting    AM    PM    Eastern Pacific Central Time Zone    

Date of sighting

Duration of Sighting    

Round Disk Diamond Triangle Oval Teardrop Rectangle Square Other Shape of Object    If other is selected, describe

Describe the sighting account in as much detail as you like.

Rain Sleet Snow Fog Clear Cloudy Partly Cloudy Weather Conditions    Lake Pond Field Mountians Hill Area Wooded River Desert Area Terrain

Other information you wish to add.

If you would like to remain anonymous please check here.   

Can we use your information for a database study.    Yes    No   

Can we contact you for further information?    Yes    No

Thank You for your information and time!

If you have questions concerning the filling out or the use of the information that is submitted via this form please contact Shadow Research at: admin@shadowresearch.com