If you have already spoken to an AUFORN investigator re your experience and would like to provide additional information via this form please reference your Callin Code and the name of the investigator.

Your Name

Mr. Mrs. Miss. Ms. Dr.

Internet E-mail Address

E-mail

Present Address

Address At Time of Incident (if changed)

Street
City
Suburb
State	QLD: ACT: VIC: NSW: TAS: SA: WA: NT: (Other)
	If other:
Postcode
Phone Number (if available)
Country

Present or Usual Occupation

Qualifications (optional)

Special Interests or Hobbies (if relevant)

Date/Time of Initial Sighting or Encounter

For Day and Month you may select a range, if necessary, by holding down the Shift key or make multiple selections by holding down the Ctrl key whilst clicking the mouse.

For Year and Time you may type a range.

Day: (Unsure) 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Month: (Unsure) January February March April May June July August September October November December

Year:

Time: AM PM

Zone: Eastern Standard Time Eastern Summer Time Central Standard Time Central Summer Time Western Standard Time Western Summer Time

Duration of Sighting or Encounter :

My Story

Please write your own account of what happened:

YES I give permission to Publish my story
No I do not give permission to Publish

Please be advised with permission given your story will be placed on our story page for all to read

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