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Does any member of your family share your interest in subjects of a paranormal nature? ____________________________________________
Do you or any member of your family have demonstratable psychic abilities? ____________________________________________________________
How would you characterize your relationship with your parents? __________________________________________
With your siblings? ______________________
How would you characterize your basic attitude toward life? ________________________________________________________________
How would you characterize your basic attitude toward a Supreme Being? _____________________________________________________________
What are your expectations for the future of our planet? ____________________________________________________________
List your primary hobbies, the ones that give you the most pleasure ____________________________________________________________________
In your own personal research, what are your special interest areas? ___________________________________________________________________
Please tell us....
Your favorite reading matter ___________________________________________
Favorite types of motion pictures_________________________________________
Television programs___________________________________________________
Types of music________________________________________________________
Sports activities_______________________________________________________
Have you experienced any of the following? Please indicate your age(s) at the time of the encounter(s).
An out-of-body experience_______________ A near-death experience________________ A life-threatening illness_______________ The death of a family member or a close friend_____________________________________
An altered state of consciousness, such as that experienced under hypnosis_________________ A trance state_____________________________________ A deep meditative state______________________________
A psychological "peak" experience_______________________________ An illumination experience _____________________________________ An intense religious experience__________________________________ A clear answer to prayer________________________________________ The presence of the Holy Spirit___________________________________ A state of grace_______________________________________________ A sense of Oneness with all of life and the universe_______________________ The appearance of a holy figure, such as Mother Mary, Jesus, Moses, Buddha __________________________________________ The appearance of angelic beings___________________________ The use of hallucinogenic or mind-altering drugs_________________
The viewing of the human aura______________________________________ Telepathy______________________________________________________ Clairvoyance____________________________________________________ Past life memories________________________________________________ Feeling that you've recognized someone from a past-life experience____________ A dramatic healing________________________________________________ A dramatic healing of others_________________________________________
Seen a ghost______________________________________________________ A Deva or nature spirit______________________________________________ An elf or fairy_____________________________________________________ An entity from a UFO________________________________________________
Contact with a UFO being_____________________________________________ An abduction by a UFO being___________________________________________
Hearing unseen voices________________________________________________ Automatic writing___________________________________________________ Precognitive dreams_________________________________________________ Teaching dreams____________________________________________________ Warning dreams_____________________________________________________
Made prophetic statements that came true__________________________________ ESP with a pet_______________________________________________________ ESP with a wild animal_________________________________________________ Spoken in tongues or a strange language___________________________________
Communication with a Higher Intelligence__________________________________ Communication with an Unknown Intelligence________________________________ Communication with benevolent spirit beings_________________________________ Communication with disruptive spirit beings__________________________________
Were you interested in the paranormal, UFOs, and the unknown before your initial personal experience occurred? ______________________________________________________
Have any members of your family or close personal friends had paranormal or UFO experiences? _____________________________________________________________
Were there any unusual circumstances occurring in your life before any of the above experiences manifested? __________________________________________________________________
Describe your emotions and any physical responses that you experienced before the onset of your encounter ___________________________________________________________________
What were your feelings immediately after the experience? ___________________________________________________________________
Did you feel in any way that you underwent the above experiences against your will? ____________________________________________________________________
In retrospect, would you now assess the experiences in general as having a positive or negative effect on your life? ___________________________________________________________________
Please explain briefly your answer ___________________________________________________
Were any of the aforementioned experiences life-altering for you? If so, in what way? ______________________________________________________________________
If you believe that you experienced "missing time" or "altered time" during any of the aforementioned occurrences, have you since received any memories of what may have taken place during those "missing" minutes or hours? ______________________________________________________________________
Do you believe that your mystical, paranormal, or UFO experiences were truly physical, actually occurring in our finite, three-dimensional world - or were the encounters really mental/spiritual ones, taking place in a dream, a vision, or an out-of-body experience? _________________________________________________________
If you received communication from spirit entities, angelic beings, or UFO occupants, do you feel that you were given any message or information that should be shared with others?__________
If your answer is "yes," please briefly summarize the essence of that message. ______________________________________________________________________
Have you ever had dreams which contain any of the following scenarios? Place a check mark in the blank in front of those descriptions that best describe your dream experience.
___Meeting a deceased loved one and conversing with him/her. ___Receiving inspiration or information from angelic beings. ___Viewing a city or a planet that appears to made out of crystal. ___Being in an unknown doctor's examination room. ___Receiving teachings in an unusual classroom. ___Being able to fly, like Superman. ___Walking in a strange, unearthly terrain. ___Viewing Earth from a perspective that seems to be away from the planet. ___Reliving what seems upon awaking to have been a past-life experience. ___Seeing people from your present-life experience in what seems to be a scene from a former lifetime. ___Drinking a peculiar, yet strangely familiar liquid, that an unknown person offers to you. ___Seeing Earth as it might have appeared in prehistoric times. ___Perceiving yourself as a member of a UFO crew. ___Observing yourself coming to Earth as a Light Being. ___Being shown a strange, unknown mathematical formula. ___Observing unusual geometric shapes and patterns. ___Attending your own funeral. ___Having the sensation of being drawn aboard a spacecraft to be given instructions regarding your mission in life. ___Watching yourself in what appears to be biblical times, communicating with figures from that historical period. ___Visiting Heaven or a higher plane of beingness. ___Receiving a glimpse of hell.
Check only the items in which you believe. ___A Supreme Being ___A God of unconditional love ___A God of judgment and wrath ___A God who both rewards and punishes. ___An afterlife in Heaven ___in Hell ___time spent in purgatory ___a period spent in Limbo ___A spiritual plateau between incarnations and/or spiritual progression or regression ___An astral realm ___A Summer Land where a vastly improved version of Earth life continues ___An afterlife created of our individual hopes, dreams, and memories ___All things eventually work for good ___Evil exists and one must be constantly vigilant ___It doesn't what we do, the earth plane is negative and destructive ___The reality of demonic entities ___Spirit possession ___Disruptive or negative entities ___Destiny ___Miracles ___The power of prayer ___The possibility of receiving direct communication from God ___The possibility of receiving communication from God through angelic beings ___Reincarnation ___The Akashic Records ___Ghosts ___Channelled messages from the spirit world ___Earth Spirits ___Dream teachings ___The ability to channel healing ___Receiving valuable guidance from personal visions ___Extraterrestrial lifeforms ___Alien contact with humans ___A government conspiracy to suppress UFO information ___A secret government that works behind the scenes of our figurehead government ___We are living in the End-Times ___We are living in an Age of Transition ___We are living in a time of Earth Changes ___We are living in a time that Native American Shamans call the Great Cleansing ___There are several alien groups visiting Earth at this time, each with its own agenda ___There are many secret alien UFO bases hidden throughout our planet ___Aliens from other planets have come to enslave us or to do us harm ___ETs are basically benevolent beings ___ETs are basically indifferent to us as individual entities and have come to study us in an objective scientific manner ___Aliens have come to create mutants through a process of interbreeding accomplished by their superior science ___The human species was seeded on Earth millions of years ago and was assisted in its planetary evolution by alien intervention ___You, yourself, are a member of an alien species secretly visiting Earth ___You, yourself, feel strongly that you are descended from ancientastronauts ___You believe that your spiritual essence comes the stars, thus making you often feel as though you are a stranger in a strange land ___You have experienced past lives on other planets ___You have felt since earliest childhood that you have a special mission to accomplish on Earth Place a check mark beside any of the difficulties listed below that may have troubled you at some time in your life. ___Chronic sinusitis ___The sudden discovery of scars or marks from unknown or unidentified causes ___Unusual skin rashes ___A debilitating physical illness ___A severe accident ___Divorce--yours or your parents ___Abusive parents or family members ___Painful or swollen joints ___Chronic neck pain Do you have any of the following? ___Extra or transitional vertebrae ___Very sharp eyesight ___Keen hearing ___Strong sense of smell ___Very low blood pressure ___An unusual blood type ___Rh negative blood type ___Hypersensitivity to electricity or electromagnetic fields ___The peculiar ability to interfere with or to disrupt the function of electrical appliances ___A "normal " body temperature lower than the standard 98.6 ___An adverse reaction to high humidity |