• ..

•

...

•

• PROJECT 10073 RECORD CARD

1. DATE 2. LOCATION

•• .:? ·s t·rn _ cl I-' ·)r-\·. ~ J ! :it on , ()'!::.. ·-~ •

----------·------------------------------------~--------------------------------~··~~--------------3. OATE·TIME C~OUP •• TYPE OF OBSERVATION r •• <'. ·} ·~ L.o

Local ,. --. ") -- - -· . O. ~Grcund· Vi sual 0 Ground-Radar

o- ' .. .. • I .. ,'), )· ~) GMT • .....

•

5 • . PHOTOS ~!,;::::;::=============-_L-r-_;C~A~I r- VI su ol C A i r·lntorcopt Rod or

6. SOURCe-·--------------~-----! 0 Was Astronomical

7. L:ENGTH OF C9SERVATION

r 't " • ' 1 - - .,I ..... Y''t _...._ .... . ..

8. HUMBER OF OBJECTS

1.

9. COURSE

0 Probably A~tronomicol 0 Possl bly Astronomicol

[j.~·: Other 1;~': .. ~.-1 l ;..; «t: l ; ~~ .. _ 0 lnaufflci•nt Data for Evaluation 0 Unknown

"'7 .!. • • •

----------------------------·-=--~--~---~~----~----~-------------·-----~~---------------------------BRIEF SUM/w\A~Y OF SIGHTING B:!."" i;;•' :_ .. ~ ... :.r .l i l:c obj ~ , 10. • """ ,., .. . > n . . ... .., -'"" - ~ j' \ ... J v . ... b c...:.. " - ·- • -" • ..: l.'"l - ~·;-!- •"\ , - .... .... .. . - • oJ

. l . , . ., . , ...... , .! '· - i.. ' ..

- . ... r..., "" - -'\ .. ..... _ _,_ .

-, ,..., . .. .., ... ·~,./ . "" --... ··. c . ' . ~ .... -· .,];) r .~. .. ~ , ,.I,. ....... .._. .. • -.....

• ... . . I" •

S ... r,.,-, n·~ ('' ,.,., ,., · .,Lo·-..,- .. ,=> •-·"" ~ ' • I 1 • ••

;~·u~.r~o.r\...! :1 t '.) : '

• - t l "'. '";~ ~ ... _ t, - 1• " . ' ., ._ .. ~a . ._ r~J. • 1.,, ' . .. -.1.1 •

, . t "'I'Q • v _ ..L ~ •

ll. COMMeNTS l~" • ' ,~ ... .l.. ......

, . • • "', •r r; " . . ... . "o

... . ' . .l •..J .._ , , c· • ' .... l • .l.

• , ' 1 .;.,, \ 1'-. ' J..

- . .. ' • •

1 .. 'l f .. ,., "' )

. ., ) - .. r l • " r • v J . _ ..1. • .. .... '-t_ ...

• , . :"l"n • • l ..... ~

. r1.~ - . , ~ .

~ •' • • ... ,.

- I · · .... ,·r~ -1

• • • 1· i "'l~ I - • I .. .

• - ( l c ,. -

t I •

.r..C:'l.O I I • • 1 .> • , - .')

f • • L. • • J.l;

. ~ . • I

,...) ••

-- . '1 .. -t , _ • • V t:!OUld h:: '1 -. • :. !l

. '

.. ' ,..., I '•

• ' .__J

-• I 0,. .. , • . .~o.o ... .... . .. " .,;

ATIC FOR M 3 29 (~EV 26 S EP 52)

-

i-1 ., Y' • -..._\._.,._ ....

•

•

• th.i ·\r . , . ••l' .l. :;;,)

- . .. ,.., -n ...... ·r---,; - .J . r:- • -) )

Cv .... ..... .. ..... , tn: .' \1 ' L v , ,.,

• 1... • .. ....,. ,. ~C l""'"'\' :-l'· .......,_ . , .... '"' v - 1 - -...

• ...,.,..... ........ , ... ~ r • . • • • · ' - .,t il ~ I ••

• '1. ~

• -I 'I 1_, ...

•• 'r•· ....... .. ., . _ ... -~ C' \, .

• • •

·-' ~· :-"' .... J. v r' - _ ,_. ~l.J - .

't.., • L 0 · .1~ ·~ . '1 • • ·-· a..n

•• , . .... - .J " ' -

• • • ' 1' ,. . ,,T' .. (. ... . "'

'\ .... 1) '--") v ....... _ ...., t _, 'J .... .... .. ~. ~ L. · - ~-.. . - . ~"' ... :.. ,., . J ~· }

• .,.., ...., ... --"- - . ' . .

1"'1~-L·. J J ~ ., 1""' I ..., , .. -.. . -• o I " ... ... ,.._ ,~ ..... , ... "} . ~ ,"' \- \ _.._ • • ,.._ • .~.. •. ~ .. i

'l • • , ~ c:. y · - , """" u- . • t.:: ·-'""" ,_.. ... v- •...J ... l ,

. ' \ - ·- . . ' , , - .. . ) ~ "- - ·--I .

'J "') , . ,. . '>,... r • •'- \ .) .... ·- - ~ .

, . . , I ].. 1"\ "(

I \.,.... .1 I

o~:· . I· .. , . • : ""'rr ) ~ -· L. ..... ,.. "t..:·J

•

..., .~..

' ·- J by

••

('13 ··--• • • • .. - ... .

• • ., • r .• j

.!: .

•

•

•

-/ N r<?~ D p ~·IV C ·, L . •

• • F.tRi,- ~~~t'fraN~

... .. . •

• •

~--------------------------~--~----~---------------------------~-----·-------------- -----------.--..·-

U. S. A I R F 0 R C E T E C U H I C A L I H f 0 R M A T I 0 H S H E E T

•

This queationnalre has been praporod so that you c:on give thtt U. S. Air ForciJ c.u much lnfCfmat ion as pOS$ iblo concerning th~ unidentified ooria I ph"nomanon tll.'l t you hov l ob~orv~d. Pl~as., try to an,wer a& many questions as you possibly con. The infNmo~ion that you giv., will be used for reseorc:h purpos~s, and will bo regarded os confidential mot8rial. Your nam• will not be u'~d in connection with any ltotemtnts, conclusioru, Of publications without your pett'mllulon. w~ requ~lt this porsonal Information 10 that, If it is doomed necea~ory, we may contact '/()U for huth~r deroi Is. · .

- - ------- --•

1. When did you seo the obiect? .2 c2. .J_ lAo. ,_ y

2. Time of day: Hour

• } l I I

Doy Month ,. Yeor

3. Tim• lone: •

(Circ:lo One): @. Ea$htrn b. Central c. Mountain d. Pacific

I •

(Circle Ona): A.M. or

( Cirdo On.,): a. Daylight Saving @ Standard

~ Ot her -------

HoME ( i.:)A c. r< 'I" R.P ) 4. Whcr:t w ~tro you wh"n you sow fh e object? , \ . ' .

- · $ I

rJ tA. b e. fL /J e ' ~ H r .s ~ .

Clty or Tow, - _D~y ro.u. Uhi~ . .

StotJ o r Cl)untry

Addl~~ :mol remarks:

S. Es'timote how long you sow the object. Hours Mlnut~u Second a

5.1 Circle one of the foqow ing to indicate how certain you ore of your onswar to Question 5.

o. Certain • ® Fairly c~r!oin

6. What 'rl!OI the conditim of ths $Ky?

(c • .- I .. , ... . -.... . . I t ;. .. _ v , • .., ,. o. Bright day light b. Dull dayl ight c. Bright twili ght

c. Not very sure d. Just a guess

•

d. Justo trace of day I ight @ No trace of day I i ght f. Don't remembe r

••

7. IF you sow the object during DAYLIGHT, TWILIGHT, or DAWN, whe re was th~ SUN loca ted as y 0u loo ked ut v '

the obiect?

(Circle One): a. In front of you d. To y our left •

b. In ba ck of y ou e. Overhoad c. To your ri ght f. Don't re morn lHH

L~---·----·-------------------- --------------------------..---.--.----------------------------·-------~-----------------~ Afi C F O R M NO. t64 ( 13 OC T ~ 4}

•

•

•

• •

• • •

•

,---------- ··-·----------·-- --·------------------·- ------··--·--- -----·-·------.--, 8. JF yr-u :J('IW the oujilct, a? NIGHT, TWILIGHT, or DAW~I, wha t did you notic r:Nl- ._,,ni ng the ST AP.S und MOON'/

r~. 1 STARS (C ircl., 0.-1o ): 3.2 MOON (CirdJ On"):

a. No no ·~} Gr i ~J }.t moon light

b. A few b. Dull mo~.·ntf ioht . (j) ~ ~:J:,y c. No m~,.,nlight - pitch dark

d. Don 't remombl'tr d. Don't j HTH,mber •

-- -- ---- ------·--------~----·-------------

9. Was lh9 ob ;~c~ brightor thon tho boc!:ground of the ~k'/? •

b. No (Circl'l Or.e): a. - '!}j) +----------------------------~~----------------------------

c. Don't r~m.,mb~n

10. ir: it WtJs sq IGHTER THAN th8 sky backgro und, wos th., brigh~ne ;s l i !<~ t:1ot ~Jf \.In outvmohil" h<1adl is;ht?:

(Circle One) a. A mi le or rnor\) awoy (o dl~tont cor)? • __ ,

, .. -. ,/. -,_ I~ I """ i¥ I

() I~

-~

/Yl 0 V I N (::, ,4 <:./'c.. (J -;. .5

S t> ""- --,-1, ~ e ., ..,. I o ?.:> K. 'I f 17.. 0 ~ ,\) () i?. ;·J, c" ~ T.

b. S.Sv~ra l blocks owoy?

c. A block away?

d. Severo I yards owoy?

e. Other .-' I : t---------~--------- --·--- ·--··--------·---------. ·- -----------------------4

•

.--o. A?pe:; ;~stand still a~ ony t1 ~ ~? · \!.!!_v b .. , v~, v ~ R./~IIT ' c. tM . Xf':":')

• ~'Jdde ... l·l speed up uncJ..ru,~-~v 0:1 onx hm~? ~ ' ~ , ::> ,. r • ~ ,· b ~ o u t! Q. r. e: ~ .o .

c . Brook l.' j) into ports or explode? Yos d. Give ~;f smoke? Yes "· Ch~ngs brightness? Yes f: Change shape? Ye~ g. F I ic ker, throb, or pulsote? Yus

(Circle Ono for ~och 'JU~stion)

No Don't :<no~ No Don't Know

J5[P OQn 't ·Know

N~ Don ' t Know Don't Know Don't Know Don't l(now

•

•

·r--------------------------·---------------------------------------------------------------------~

12. D ld th~ object move b3hind somethi ng at anytime, particularly o cloud ?

(Circle One) : Yes (~ Don't Know. IF you onaw~r-1d YES, than tt!U what

it moved bah ind: __ ------------·------------------

-----------------------------------------------------·----------------------------------------- ------------------- ---------------------------------------------~

' 1 13. Did tho objec~ :':i~·,..e in front of something ot anytime, p:Jrtic•Jiarly o cloud?

Yes Don't Know. . d . . . 1 t move : r. · -~;.! ::. r ; - --------------·------ ----------------------------------------------- ------------------------------------------------------ --------------

•

------------------------------------------------------------------·-----------------------~ '(;":) Solid?

' '-'"' b. · T rons()or ~nr? 14. O:d ;ha objact appear: (C ircle Ona):

~-------------------·------------------------------------------------------------------·------~

l ts . Did you oi:>servc tn3 objoct through any of tha fo llowing? •

I I I

I I

o. Eyaglossc~ Ye-. (~1:)1 e. Binoc ul ar s Yer; ,tq9. b. Sun g l a~se s Ya.:. (~9> f. Tolc .:>•:op~ Ye~ ~~8

-~ -~ t.: . Wind~hiold Yo:. N g. Theod " l l~~ Y"J j:t ->'

h. OthJr _ __ . __ _ L:L·v_~:· _ _ oj~.-J . .::>fii- _Vi .~vl'Jj d. '1/ind'ow glnss y cs

I

··-------------·-----·- -----·-·--------------------·-----------------'

•

•

•

• •

•

•

• •

• •

• •

, __ ........ _...___ .. ___ ......._ ....... ___.. ______ ~·--""---------·------·~----·-----·-------· .-.----------·--~----~-·- ·l

16. T otl In o fow words the foll owl n3 thing.1 obcmt the obl t~ ct.

I i a. Sound ___ NOt!...£.. _ _____________________ . _____ _

b. Col .>r _ .... 63L. ~vtl ~It - } t<. -~ ' . I . .

... !., f),...h~ .. .rl • ...;T.._.;,o;F.....,. __ .;:;.;C-~~..1.f~~.;..;E...;.... - .. --J.J..:..::J;.;..IC:~~ .... ';o;..;..,!,!_, .:.!".-~...:...-:. , _ )

---( .....

• . _; -·-- --r

I (' r · •

~ (',:'j t ov - - --s.-~----------------------·------------------1~· I - ·--··· •

t

r I t

I

I I • I

I

I

I

1 '

I I I I

I ' I I • I I

' • I

I

I

17. Dr~P¥ o plc :ure thol wiU show tho !hop" of th~ obi"ct or oL!tJc~s. Loh.-,1 a,td ln.::lud-.t In i'our 1k<ttch Oil/ JJt~ll~ of lh• o'->1 )C:t ·tJ.,at you 3CJW soch U'l wlng5, prolrUIIIon ·t, • .,~,;., ond D:sp~clally u><ht.J uJ t traits ''vapor tro lls. PI·,<:J on urr'lw etta ide thtt drawing 1o !th\JW th'!) dlrocflon tha obj:tct wa l rn~vlnCJ •

•

•

•

l s. Th~ ad Gg l -; ~the obj~ct w~ra:

(Circle o~s): a. Fu::zy or bl urr.ad e. Other __ - -~<£) Ll~., a brigh~ s t-:Jr

e. Sharply outl ined d. Don't remttmb~r -

19. · If there was MORE THAN ONE object, than how many WC)ro there? -----~------- -· Draw o pictur~ of how they w&ra orro .,g~d .. and put on arrow t.l shQw 1he dir~ction that thooy Wf)ri! traveling.

IVA

•

-- - ------------··---·-- _ .._ __________ _ ----- --~----- - -·- - - -- - ... - - ... -

•

•

•

•

•

•

•

•

•

I

I

I I '

• • •

P o.g t A

-----~------------·---------- ------·---'-· ----·-~----~-----~-~- ----,... . ... -·---- - - - - - . ...... _ . _ _______ 4 ___ _

-~--·-

20. Drow <:J plch1rG thnt w LII !lhow the motl~n th~t tha obi-,ct ~.' obj8r.tl mnc!e. PJoc" 'On "A" o t th" br,~fnn l~ ol lh.tt poth, o "8 19 of tho ~ nd of th<J patn, and ~ho.v anY, chun!Jetit In d lr.,ctlon d ur ing ?he cllurs,.,.

;{/>;1 0 b .... 1·e r::. '"I • :; e e "" c: .I:> -~~·o -j o I/o :.J A

S. ~ \1. r 0 N. E. . A ~. i f· / t\) r. ) t? b ; 1 .

,~ r> , .. t,

, - • .:.. .~ C: ... ~ T , _ . , I

C: {?_ {( /} I I '- -t

f R.. 0 f\.1\ ~ ( v ff:

- ::::> L ..> w ; ,•J6 ,., J I )

rJ.t:. . I

e r .A./C. 5 .. _

1,VLJ •

.:.. p ec: Dt'16

•

-·-·--------------·-------------------------------------~-------· ------1 21. JF POSS I BL ~, try to g 1.1e :ss or e •;HnYJt.J whot the r.:>o l ,.;.,., of tha obi.,t:t wo~ ln it:s long tt lf di tfhltw,ion.

• • -~-.. - feet.

~-----------·-----------------------------------------·-----------·---------------------------------------------------~

I I I

12. How lorg~ did the ob ie ct 9' ob j ~ch <lp~or oa compotdd with CrnJ of ~he 'tol lowl ng ob j;,c:' !S hll'J id in t fHt hone/ ond ot abovt crrn'!l lttngth?

(Circ le On~) ; a. Htlad of o pin g. Silver do Jlor b. Po a h. Ba~obo ll c. Dime I . Grope Fruit d. Nickat I . Bask~tba ll 1!1 ,f TI_j, ~I e A.b e. Quartet k. Othar .

f. Hoff dollar ~

I ' ' .... 22 . 1 (Circ!e Or~ ,,r tho foll owing to ind:.:~ttt how .: '!trtoln you ur.:t of your o n 'Jwar to Quasl lon 22.

a. c ,rto in

(b)Foirly co.'!r~~ln c. Not vary suro

d. Unce rta in ~--------------------------------------------------·--------t

I

• •

I ;

! J • • l I ! I

l I I

I • I • . •

23.

24.

How d id the ob j~ct or obiech di so;:> ~cr from via w? AP£_D ,o.J- T '?o· c.- TO . ,

3 0 ° fth_ D lJ C. h . tJ /?_ I '?!. 0 f...) • 0

• •

1r ~ t

•

l n.. c:ud•' t l:tet y•w coA·th•• oa d~or o p letr.sr.-os poialbhr of-wh et yow t tt w, WfJ would Woc7 f"r }-oo1::J hnogh1& thot yo u eet,~W­

con-~hw•f the obj,et lflot yeo set~¥. Cf wt1ct rype nrl:2te r1ot wcsohf fOtJ n1olce lt?--tto., for' ' wobM H hw, o11d wh.nt·~h-a~

w~t~Jd ;,. Lo,.s? fj)~ a c:rl he In your own words o ~ommon obj'!tc:t or obi• ch which wl,an p' oc~d up In th-. • l< y would g lv"' tne

aume "PP~arane-. ~ • th e obJ~ct w}, lch 'fOIJ t ow-;}

f) . '"'< ..... t/. ~/ Ia ..... " "'- r a ,:::. {.._") l~ E c ..4 0 J A T c I/ 1-F-........ 1.;.; :...-... T I I / \ J ..... '"" ..;> ~ .....

( •

.\ 1 •• - ,I \ • • • ' ,J

• •

•

.. __ -------- ---... --·-- -- - ··---- -·· -· .. ··--· - ...

25. WhNe w~r ~ yo u I.JC\Jkcl wlhHl yotJ '>C•" thv object? (Circlo One):

a. ln:;iJl} a building l>. In u cor

' ( ... - .".J o~.. ~ Jv:)f'J --· d. In ,, n air pl ~o..na e . At .;; •! u

f. Ot •.t:'r -·--- .... - ------ .. - ·- - - ... ---- __ _

·-

, \ (. , ( 1 •

. - . . -- ----~- ·-- - ·- -· --- -

u . I n t Ill ' u u .. i r • ~ s ~; s ~ c i i v n of \1 c ' t y ') (h'" I n th e r :~icl .m ~ iul s~cti on of o c-iry?

c . l11 opon ~o.O\m trys i de?

J . Fl ying ll t)c.t r an airfi · lcl '~

\! . F lyi nu <w .. ·r u c ity? f. Flying ov ~,; r open co1 . .111 t: y?

- -

u. Otl1er -·· . .. . . ----- - - --- -----· -- - ·- __ __ _

... - ---------- ···- --·---- ·---·---- - - ·- · -----------·-- - - · ·- -~---· ---·---·--·- -·- --·-- --- - - .- ... _ • • • I •

27. Who~ w -:or~ y •:~u d~ina at tho ti me you sow th;: nbl "~ct 1 and how did you happen to 11otrcc it?

•

---·--------·-------·-----------·---------·-------------------- - - --,

-· • _ _;;;,. ___________ .____ ...... __ ... -·~----·--~---------------------------·----- .. ··-- -· I

1---------·-----~--- -·-·----·- ------·----·---·-----·- - ·----·---- --------------

•

. 23. IF yo .: w~r~ MOVING IN At~ /1 UTOMOBILE or other v e hicle at the t ime, then cornpleto the fo l lowin~ que•:tions:

28. 1 Who t d i recti on were you rnovi ng'? (Circle One)

a. North c. East ~ . South I

Northeas t I Southe(ISt f. Sou thwcs t .... a . <J'

b .... fas t were y ou m~.1 •• ~? ------·---~----miles pe r hour .

2 ..... , 0,...; )id you stop at cny t ,Te whi le you wera look:ng or the: object'?

(Circle One) Y es No

29. What d : ~ ec t ion were you looking whe-n you first sow t h~ obj~ct? (Cit d e One)

a. North (9 Northeast

c. East d. Southea st

e. South f. Southwe:; t ......

30. What d irection were you looking when yo u last saw the ob ject? (C ircle One)

-.1. ~:or th c . East e. South f. Southwe~t

•• • \ • I t t ;,. ,·: :>rtn eo s ·.., .../ d. Southeast

g. West

h. Northwest

·'

•

g. West

h. Northwe!l t

g. Wes t

h. Northw~s t

~------------------------------------------------------------ ·--- ----------------------------------------------·~

31.

I

If Y"U :: -~ ::; ....... l ior w it !' b~o r i ns term" {a n0 ulor dir~~tion), try to estima te the numO....r o f desre~s th~ object was

from tr\.t:: =· 4 :1 and ulso t he number of dcsrces it was upward from the hor izon f~·lovat i on) .

31.1 ( . .....-\

Wh~n it fir s t o ~pcorcrl : ..;J-0° . - ~ J

h -~-;i?J#' d a. From true ~! art __ cj _ - ·--·- egrees .

b. From hori 7.on . _ '?l~Q ~- ~ rbwccs .

•

31.2 ' l ' i t d i ~a p p cc., (' rl . ) /nen . .. a. Fror·1 tn ; ::- t lor th

J_ /_ ,

'TN c~· :; r ccs .

L. Fr•)m h n rlf.O II 30 dcq rt'~r· s. . - ·- ~

I I I

I :..__ ---- ... ____ ---·------------ ·-··'"· -·- ---·- --·- --- ---------- - - ... ,._ - --· - ·- _._ -- -· ---- - - ... .....

•

•

•

•

•

• •

• •

r------------~------ -- -""--- -----------------·--- · ------------- ----------:3 <1 . Whu t wc ro the weu th:.:r co nd itions at tho ti rnu you ~ow the ohi •1c t?

34.1 CLOUDS (Ci rcle On J)

~J C lvar <; ky b. H <:1 ~y c. Sell tter~d c loud~ d. T hic k or heavy cloud!i e Dor ' t rernemb~ r

34.3 ',~ t: A ThE R (Circle One)

(a'.· Ory ~·. = vg, •n is t, or li ght ra in c. Moderate or hea vy ro in

d . Snow

34.2 WIND (Circln On:!)

o. No wind b. Sl inht broc t e

c. Strong wind

(~ ,) Don't rcme,mher

34.4 TEMPEl~ATUP.E (Circle One)

a. Cold b. Co ol c. Warm

(~; Hot e: Don't remember e. Don't re me mber - _ _. _. _____ ----- ----··------ ------------------1

~----·----- - - -- - - ---0 /$') - e A 1/ e..o vJ r A F !j

35. When d 'd yo u repor t to some o ff icial that you ha d seen the object? \. o D-' _, z -, L \.oJ.,:,OJ ----<'"-~----·- ___ . sJ _,__ __ ~,- ~\ ------- ---- FT » . 0 l) Ot.Jy Month Yeor

•

--------------.----- - ·-. ----- -·------------------- -------------- -- -·--- ........ -·----

36. Was a nyone else with you pt the ti me you saw the object?

(C irclc One) (f..i]) No

36. 1 1:= you onswered YES, did t:,ey see the ob ject too?

( C ir:: /e One ) ~ No •

36.2 P!<!c St:t list the ir nome s ~nd addresse5: (A oP R~ .._. ~

b c:.. I ~J . ...; ) f. ; ~ ~ tl\ r~s

t1 ,\)j)

; V c·, ~rl bo r-~ I /} j).f;J /~ ~ 5 ~ o-V.J J:...l'./ 0 ,v ~)) \..

• ~----------·----------------------- -------------------------------------·----------------------------------1 37. Was this the first time that you hod seen on object or objects I ike this?

---=--, (Circle One) \._'Y.:;y No

37.1 IF you answered NO, th e n whan, where, and under what circurnstonccs did you see other ones?

_ _ ___ ,flr,_;;....LAd~__~nr-_ _r S c _e tV -~ <-< r !rl ;g;_· t:5 o .os. T ~,-,:. H ,;{ D. .£ c h o

:- .c; __ T c: (/ t -T-~

------·--- ----------------------------·----------- -----------------------·-------------------------·-------------- ---·-- -----------------

.__ __ __ , ____________________ --·------ -----------------·-------------------------38. In your opin ion what d-, you thi nk th e ob jec t wa s aild what might have ca used !t?

/ he..,~. & HT i T W l'l'S o f:j < .. !~T (' ~ : £c.),o1

~tJt ... Tv;-< clrj / ."'-' 0 z.L) ;.-, .DVI.c.

• • - To ~ tDC. . ,_::. ') ,j IV (;, £ ~ • '! I "'-" J.:J /J .V .T) IO

• •

:.>r) ~ t:.:. J) o 1 0 ~..) ::.. '- T

-•

/ ,.., ' • ·~;!_J;> --

-~..) h ~ .,.) :::> /:~-.} c::' c ~

r,_, ..) '""- ., H T • I T

J} .. 0 ·t:. t A J I tJ u v . I

-------------------------- --- -------- J ---- ·- - ---- ----------------·--5 c. •• :: c:_,~ ~ J)

•

•

•

•

•

... ________ ._____ --·- - . ...-. -· .. - -· --. -· ---- - -- -- --·- •-'--·--- --- -- . .... ---· -·-- .... -·· ·= --- --.-- -------- , •

• :19. Do you thi,,~, yov con c;: .,ti moh: t iH., ' ; 1n•: I vf the t' bj t:cf?

~ lu ;..1 ...__:. ~ -.J t. L /1 c) I __ ___ _ ___ nl.f),r, .

-- ·- -·-·· ·-- - -- ····- -- -- - · -·-·-- - - -- ~-. ... ----·-·------- .... - .. -- -- ·-·- ·- --- - --

40. Do you thin '< you can cstirnot•J how for C:IW<"~Y frorn you tho obj..: •.:t ·.vos'~ • (J () ..) ...J I '-.> J ._:. ' j-f. I & 1-J ---

----- ----- --. - ---- · .. -·- - -- - -·-- ·---------------- ----. ___ ..... - · --· ~--·· --- ·---------------- - -

- ----- -·- - - - -Miridl~ Nom~

•

NAME First lt<.~mo ------ ----

. ~ . 0 h t Q - - ·-

Sto td

Whot i :> - our pre sent job? -----------·-------~·----------~-0 fl !_·L._c __ r< __ ; _:J_0_11t ~£<c c.. ·)

Sex __ ~~.1.__ - - ---·-•

Pl~as:: ·"di~are ony speciJI c: JCC~i .:mal training that you have hod .

• e. e . Technica l sc.hool - - - - - ·--- ·-------

o . Grode schoo l .------ -··---- ----·--­

b. h igh schoo l ----(Type) _ __ ------------------

------- - -·----- - -f. Olh er spc:c ia l tra ining --------------

c. College-----------····------·-

d. Post graduate ----------- ---------------------------------------- -·--- ·--------_.-.... --

-------- ·--~- - -- ·------ - -------- -------------------------------- ---------- - ·---------( -1 l.:z_l_

( 0 ~- oo E~r) 2.. _:1 _ _ _ 42. Date yo0 t:oT'plated this qu~st ~·~ 1nail'e : D a y

- -;- I ;__.,

• .• ,.---~i _!L

, - •*

J

Y oar

--,

• I J r•

,

I • •

I --· • ·---- ......,_

1 • 1

' • I I I • I

\ I I

I '

\ I I 1

I ·- --- · ~ -- - --- -- ---- ·- - --· - ... .. . - - -· - .. .. -- - -··- - - --- ---·------ - -·---- ·-------------·- --· ----- .... . ... --

•

•

•

•

•

• 0

• Q