Your Address
Your Name
Your Address
Your Phone Number
Your Email
What is the best
way to contact you?
The best time
to call you ?
Morning
Afternoon
Evening
Anytime
ASAP
Email
Phone
(You must be at least 18 years old to arrange an
investigation with C.O.R.U.P.T. If you are under 18,
please have a parent or guardian contact us with in
48 hours of submitting this form)
Please describe the activity taking place. Be as
thorough as you can, giving dates, times, places, and
witnesses of the activity. Please also describe the
emotions you were feeling during the activity.
Describe Activity
Yes
No
Have you recently lost a loved one?
Yes
No
Do you believe in ghosts?
Did you believe in them prior to the current events?
Yes
No
