Date of event:      

 Time of event:     

 Time zone:            

 Duration of event:

 City:                     

 State / Province: 

 Country:             

Describe the nature of the activity or event you witnessed.  Give as much detail.

Any other information concerning the event that you would like to share.

------------

 First Name:   Last Name: :

Can we contact you for more information?   Yes No

If yes, please list a phone number, mailing address or email.  This is confidential!

May we give a brief overview of this report to be placed on the Shadow Research website.  No personal information will be given.  Yes.  No

-------------

Thank you for your time and information! 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: reports@shadowresearch.com