Springfield Ghost Society Investigation Request Form

Please provide the following contact information:

Name
Street Address
Address (cont.)
City
State/Province
Zip/Postal Code
Country
Work Phone
Home Phone
E-mail

Will this be a new investigation?

Yes No

If you have had previous investigations please enter the date of the last investigation :

-- mm/dd/yy

What has been happening to prompt you to contact me?

How many years have you lived at this house?

How would you rate your concerns on a scale of 1 to 5?

1 2 3 4 5

Do you have any other information you feel is important? Do you have a cell phone number?

Best time of the day to contact you: