Name & Address:

First:
 *

Address of Property To Be Investigated: *
 Check here if same as above.
Address:
 
City:
 
State:
Select NY PA OH Other  
Zip:
 

General Property Questions: *
Check all that apply
 You own the property.
 You rent the property.
 You know the owner or renter.
 Residential
      Single Story      Two Floors      More than two floors
      House
      Apartment
      Other
 Commercial
      Business
 Other
      Church
      Cemetery
      Park
      Other

General Client Questions: *
Fill in all that apply - If this is a commercial / other property not residential most will not apply.
How many people live at the residence?  
How many children if any?  
If there are children have they been affected by the activity?   Select Yes No
Are the residents feeling threatened?   Select Yes No
Is anybody at the residence disabled or ill?   Select Disabled ILL Other
How long (in years) has the activity been happening? (enter 1 for less than 1 year) 
How many Pets if any?         Dogs   Cats   Both   Other

Paranormal / Unexplainable Activity: *
Check all that apply
 Unexplained Noises   Strange Feelings   Visual Experiences   Movement of Objects
 Strange Behaviour     Hearing Voices     Electronics Malfunction     Recorded Data
 Touching, Pushing, Scratching    Other

Please type a brief explaination of the activity  that has occured or is occuring in the box below.
 -Required

Click here to submit your application, and we will contact you via email or phone. C.C.P.G. may require more information before accepting an application, and if accepted you may be required to fill out a few other forms for legal reasons.