Please complete the following form adding as much detail as you can provide.
1. Did your experience occur
To You
To a Family Member
To a Friend
I just heard this story and thought you might be interested
Other
If ‘Other’, please describe:
2. Your Name: You may submit anonymously. However, doing so may forfeit any options of publicity (web, DVD or other) in which case your experience will become a part of our private collection for personal research only.
3. Contact Phone: Email:
Tell us about the haunting and your experiences
4. With as much detail as possible, please tell us about your experiences including how it made you feel and any personal insights or impressions you had during the experiences. Include any stories of events you may have heard from other people.
5. Please provide as much detail about the haunting ‘source’ as you can:
What / who causes this haunting / paranormal event?
I believe it is a spirit (ghost) of a deceased person
I believe it is a spirit (ghost) of an animal
I believe it might be what is called a ‘Demon’
I believe it may be caused by some ‘natural phenomena’ not yet explained.
I’m not sure what is causing the events
Other (or elaborate on any of the above)
6. If this is a spirit (ghost) of a once living person can you provide any details about them while they were living so we can accurately research and document their history?
a. Was this entity Male or Female while living? Male Female
b. What was their name while living?
c. What was their occupation while living?
d. Do you know the birth date and death date? Birth: Death:
e. What period were they alive? (mid 1800’s, early 1900’s etc)
f. Approximately what day / year did they die?
g. What was the circumstance of their death? (Suicide, Murder, natural causes, etc)
h. Personally, why do you think this entity has remained here? (i.e. it was their home or unfinished business, etc)
7. If the entity is not a deceased human, but rather something else (‘demon’ natural phenomenon, animal, etc.) can you give us your best opinion on what you think may be causing the paranormal events? Include any details as to how it may have come to haunt your property:
8. Can you please describe the nature of the paranormal events? Exactly what occurs?
9. Do the events seem to occur more frequently around a certain time or date or around certain people?
10. Does this haunting harm anyone or ruin / destroy property? If so, can you explain?
11. has this entity ever been known to be helpful such as warning or danger, etc?
12. Do you know who first experienced the paranormal activity associated with this haunting or when the hauntings first began?
13. Has anyone else experience the events? (Family, friends, etc). Yes No
14. If others also experience this, is it possible to provide us with their contact details? Important: You may want to contact your witnesses first to ask if they would mind if you give us their contact details. Some people may not wish to be contacted un-solicited. If they are customers please ask their permission first so as not to jeopardize business relationships.
Name 1: Phone 1: Email 1:
Name 2: Phone 2: Email 2:
Name 3: Phone 3: Email 3:
15. Do you believe that ghosts and / or paranormal events are real? Yes No
16. Do the paranormal events in your life scare you or bother you in any way? Yes No
17. Do you feel a ‘presence’ or ‘energy’ of some kind in certain areas? Yes No
18. Have you ever experienced ‘cold spots’ in the building in question which cannot be accounted for? Yes No
19. Have lights or electrical devices (TV, radio, etc) ever flickered or turned on/off for no apparent reason? Yes No
20. Do you feel there is ‘intelligence’ behind the haunting or paranormal events as if it were consciously aware of its actions and other people in the room? Yes No
21. Has the ghost ever interacted with you or someone you know of as if to let you know its there? (For example, someone might say, “I don’t believe in ghosts” followed by an odd banging or thumping or a picture falling from the wall which seems too coincidental) Yes No
22. Have you or anyone you know ever tried to communicate with the entity causing the haunting? Yes No
If yes, what happened?
23. Do you know if any particular animal seems to be around more often when the paranormal events occur?
24. Do pets, such as dogs or cats seem to aware of an unseen presence? Do they become anxious or agitated?
25. Do you pets seem to avoid or prefer certain rooms or areas of your building?
26. Have you ever had the phenomenon investigated by professional ghost hunters or psychics? If so, may we ask who? Yes No
Results of investigation:
Publication Permissions
27. Would you consider being interviewed on film for our Haunted Australia DVDs? Yes No
If not you, personally, is there another member of your team or family who would be interested in appearing on film?
Contact Name: Phone: Email:
28. May we film and photograph areas of the property in question for possible use on Haunted Australia’s DVDs? Yes No
29. May we publish your story and experiences on the Haunted Australia web site?
Yes Yes, but with certain restrictions (explain)
No, not at this time
Again, John and Lia Ramses would like to thank you for taking time out of your day to share your experiences with Haunted Australia. We look forward to receiving your questionnaire to add to our research of mystery and phenomena.
If you have any questions or comments concerning this questionnaire, Haunted Australia or Anomalous Films please feel free to contact us any time during normal business hours (8 am to 7 pm – Monday – Saturday).
For Haunted Australia queries:
Lia Ramses Mobile: 0407 655 109 Email: Web Site:www.haunedaustralia.com.au
For Anomalous Films or DVD queries:
John Ramses Mobile: 0438 248 358 Email: Web Site:www.anomalousfilms.com
Confidential Voluntary Information: Answering the following questions in the gray box is entirely voluntary. The answers you provide to questions in the gray box are strictly for compiling statistical data for our own personal research. Answers provided by you will not be made public without your expressed consent. The purpose of these questions is to attempt to establish a common thread, if any, between those who experience paranormal events and those who do not. Also, it has been suggested that many children, maturing through adolescence into young adults, demonstrate an ability to unconsciously manipulate electrical gadgets and cause ‘supernatural’ events in their vicinity (such as moving objects, sounds of running, walking or closing doors). There seems to be a direct link between some such events and the child’s emotions (which are often moody during this age range) and an exchange between their natural body / mind energy field and that of the earth and their surroundings. Feel free to leave any or all of the questions un-answered.
1. What is your age?
2. What is your birth day and month?(for determining zodiac)
3. What is your religious background / influence?
4. Are you currently active in your religious practice?
5. Have you experienced psychic or paranormal events throughout your life before this particular haunting?
6. Has anyone in your family experienced paranormal events in their life before this particular haunting?
7. How many siblings do you have?
8. Are you married?
9. Do you have children?
10. If you have children, have they ever experienced or talked about something happening to them which could be considered paranormal?
11. Is there an adolescent (age 7-14) child residing on the property in question?
12. While nearly all children have imaginary friends as part of a normal childhood, did you ever have an imaginary friend as a child which, to you, seemed as real and living an ordinary person?
13. If yes, what age range were you and what was your approximate age when your friend stopped coming to visit?
14. If you have children, have they ever told you of imaginary friends in their lives?
15. Do you ever experience psychic events such as knowing when a phone will ring or when something has happened?
16. Do ever see certain number-sets on clocks or elsewhere with such frequency as to make you take notice and wonder if it might mean something? Yes No If yes, what numbers (or specific ‘Time’) do you see most often?
Please complete the following form adding as much detail as you can provide.
1. Did your experience occur
To You
To a Family Member
To a Friend
I just heard this story and thought you might be interested
Other
If ‘Other’, please describe:
2. Your Name: You may submit anonymously. However, doing so may forfeit any options of publicity (web, DVD or other) in which case your experience will become a part of our private collection for personal research only.
3. Contact Phone: Email:
Tell us about the haunting and your experiences
4. With as much detail as possible, please tell us about your experiences including how it made you feel and any personal insights or impressions you had during the experiences. Include any stories of events you may have heard from other people.
5. Please provide as much detail about the haunting ‘source’ as you can:
What / who causes this haunting / paranormal event?
I believe it is a spirit (ghost) of a deceased person
I believe it is a spirit (ghost) of an animal
I believe it might be what is called a ‘Demon’
I believe it may be caused by some ‘natural phenomena’ not yet explained.
I’m not sure what is causing the events
Other (or elaborate on any of the above)
6. If this is a spirit (ghost) of a once living person can you provide any details about them while they were living so we can accurately research and document their history?
a. Was this entity Male or Female while living? Male Female
b. What was their name while living?
c. What was their occupation while living?
d. Do you know the birth date and death date? Birth: Death:
e. What period were they alive? (mid 1800’s, early 1900’s etc)
f. Approximately what day / year did they die?
g. What was the circumstance of their death? (Suicide, Murder, natural causes, etc)
h. Personally, why do you think this entity has remained here? (i.e. it was their home or unfinished business, etc)
7. If the entity is not a deceased human, but rather something else (‘demon’ natural phenomenon, animal, etc.) can you give us your best opinion on what you think may be causing the paranormal events? Include any details as to how it may have come to haunt your property:
8. Can you please describe the nature of the paranormal events? Exactly what occurs?
9. Do the events seem to occur more frequently around a certain time or date or around certain people?
10. Does this haunting harm anyone or ruin / destroy property? If so, can you explain?
11. has this entity ever been known to be helpful such as warning or danger, etc?
12. Do you know who first experienced the paranormal activity associated with this haunting or when the hauntings first began?
13. Has anyone else experience the events? (Family, friends, etc). Yes No
14. If others also experience this, is it possible to provide us with their contact details? Important: You may want to contact your witnesses first to ask if they would mind if you give us their contact details. Some people may not wish to be contacted un-solicited. If they are customers please ask their permission first so as not to jeopardize business relationships.
Name 1: Phone 1: Email 1:
Name 2: Phone 2: Email 2:
Name 3: Phone 3: Email 3:
15. Do you believe that ghosts and / or paranormal events are real? Yes No
16. Do the paranormal events in your life scare you or bother you in any way? Yes No
17. Do you feel a ‘presence’ or ‘energy’ of some kind in certain areas? Yes No
18. Have you ever experienced ‘cold spots’ in the building in question which cannot be accounted for? Yes No
19. Have lights or electrical devices (TV, radio, etc) ever flickered or turned on/off for no apparent reason? Yes No
20. Do you feel there is ‘intelligence’ behind the haunting or paranormal events as if it were consciously aware of its actions and other people in the room? Yes No
21. Has the ghost ever interacted with you or someone you know of as if to let you know its there? (For example, someone might say, “I don’t believe in ghosts” followed by an odd banging or thumping or a picture falling from the wall which seems too coincidental) Yes No
22. Have you or anyone you know ever tried to communicate with the entity causing the haunting? Yes No
If yes, what happened?
23. Do you know if any particular animal seems to be around more often when the paranormal events occur?
24. Do pets, such as dogs or cats seem to aware of an unseen presence? Do they become anxious or agitated?
25. Do you pets seem to avoid or prefer certain rooms or areas of your building?
26. Have you ever had the phenomenon investigated by professional ghost hunters or psychics? If so, may we ask who? Yes No
Results of investigation:
Publication Permissions
27. Would you consider being interviewed on film for our Haunted Australia DVDs? Yes No
If not you, personally, is there another member of your team or family who would be interested in appearing on film?
Contact Name: Phone: Email:
28. May we film and photograph areas of the property in question for possible use on Haunted Australia’s DVDs? Yes No
29. May we publish your story and experiences on the Haunted Australia web site?
Yes Yes, but with certain restrictions (explain)
No, not at this time
Again, John and Lia Ramses would like to thank you for taking time out of your day to share your experiences with Haunted Australia. We look forward to receiving your questionnaire to add to our research of mystery and phenomena.
If you have any questions or comments concerning this questionnaire, Haunted Australia or Anomalous Films please feel free to contact us any time during normal business hours (8 am to 7 pm – Monday – Saturday).
For Haunted Australia queries:
Lia Ramses Mobile: 0407 655 109 Email: Web Site:www.haunedaustralia.com.au
For Anomalous Films or DVD queries:
John Ramses Mobile: 0438 248 358 Email: Web Site:www.anomalousfilms.com
Confidential Voluntary Information: Answering the following questions in the gray box is entirely voluntary. The answers you provide to questions in the gray box are strictly for compiling statistical data for our own personal research. Answers provided by you will not be made public without your expressed consent. The purpose of these questions is to attempt to establish a common thread, if any, between those who experience paranormal events and those who do not. Also, it has been suggested that many children, maturing through adolescence into young adults, demonstrate an ability to unconsciously manipulate electrical gadgets and cause ‘supernatural’ events in their vicinity (such as moving objects, sounds of running, walking or closing doors). There seems to be a direct link between some such events and the child’s emotions (which are often moody during this age range) and an exchange between their natural body / mind energy field and that of the earth and their surroundings. Feel free to leave any or all of the questions un-answered.
1. What is your age?
2. What is your birth day and month?(for determining zodiac)
3. What is your religious background / influence?
4. Are you currently active in your religious practice?
5. Have you experienced psychic or paranormal events throughout your life before this particular haunting?
6. Has anyone in your family experienced paranormal events in their life before this particular haunting?
7. How many siblings do you have?
8. Are you married?
9. Do you have children?
10. If you have children, have they ever experienced or talked about something happening to them which could be considered paranormal?
11. Is there an adolescent (age 7-14) child residing on the property in question?
12. While nearly all children have imaginary friends as part of a normal childhood, did you ever have an imaginary friend as a child which, to you, seemed as real and living an ordinary person?
13. If yes, what age range were you and what was your approximate age when your friend stopped coming to visit?
14. If you have children, have they ever told you of imaginary friends in their lives?
15. Do you ever experience psychic events such as knowing when a phone will ring or when something has happened?
16. Do ever see certain number-sets on clocks or elsewhere with such frequency as to make you take notice and wonder if it might mean something? Yes No If yes, what numbers (or specific ‘Time’) do you see most often?
