The NJGR Assistance Request Form

NJGR Assistance Request Form
Name:
Email Address:
What is your mailing address?
What is your phone number?
What types of strange activity have you noticed in the recidence? strange sounds or knockings
disembodied voices
strange odors
cold spots
hot spots
manipulation of solid materials
high electro-magnetic fields
specific patterns of activity
Do you have any adolescent children in the residence?
Has this activity begun just recently?
Do you consider yourself to be a skeptic?
Does this activity frighten you or make you feel uneasy?
Would you consider yourself to be a spiritual person?
Would you like to know more about the activity in your home?
Would you like to make arrangements to have a preliminary investigation done on your home?
Would you like to speak with a representitive of the NJGR organization regarding the activity?
Please Provide us with your input as to what is occuring in the residence.
Are you the only witness to this activity?
If there are other witnesses to the activity, please provide their names and ages.
Please provide us with a date which would be suitable for a preliminary investigation.

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