Are you:    M/F (please check one)

M     F

 

Age group: (please check one)

15-25    26-35    36-45    46-55    56-65    66-75    76-85     86-95

 

Have you ever heard, seen, or felt the presence of a ghost?

 Yes     No

 

Has any member of your family heard, seen, or felt the presence of a ghost?

Yes     No

 

Would you like to see a ghost? Y/N

Yes     No

 

Comments welcome!