document.write('<script type=\"text/javascript\" src=\"https://assets.bravenet.com/bn/js/emailfwd/bn_email_forms.min.js\"></script><link rel=\"stylesheet\" href=\"https://pub33.bravenet.com/emailfwd/v2/bnet-form.css.php?usernum=2798844518&formid=4023&formpadding=0\"><form method=\"post\" class=\"bnet-form\" enctype=\"multipart/form-data\" action=\"#bn-ajax-post:2798844518:33:4023\"><div class=\"bn-form-header\"><div class=\"bn-form-legend\"><div>Paranormal StakeOut Paranormal Event Report Form</div></div> <div class=\"bn-form-desc\"><p>All information in this report is for investigating the reported Paranormal event below. The person submitting this report to Paranormal StakeOut for investigation declares that they are the age of majority in the judicial area where they live.');
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document.write('The information in the following report will be entered into the Paranormal StakeOut database and be made available to other Paranormal Investigators, Teams, Groups, and Organizations, except the name, address, and contact information of the person making the report and person(s) mentioned in this report unless permission has been given to do so.');
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document.write('Please note that if any information provided by you is shown to be misleading, false, or fabricated, even if unintentional, this report will be removed from our database.</p></div></div><div class=\"fields-wrapper ui-sortable-handle\"><label class=\"bn-row\"><span class=\"bn-label\">Name </span> <span class=\"bn-input\"><input type=\"text\" name=\"Field-1\" placeholder=\"your first and last name\" validator=\"\" value=\"\"></span></label></div><div class=\"fields-wrapper ui-sortable-handle\"><label class=\"bn-row\"><span class=\"bn-label\">Email Address <span class=\"bn-required\">*</span></span> <span class=\"bn-input\"><input type=\"text\" name=\"Field-2\" placeholder=\"you must enter a valid email address\" validator=\"email\" required=\"required\" value=\"\"></span></label></div><div class=\"fields-wrapper\"><label class=\"bn-row\"><span class=\"bn-label\">City and State/Province </span> <span class=\"bn-input\"><input type=\"text\" name=\"Field-1679445588811104\" placeholder=\"\" validator=\"\" value=\"\"></span></label></div><div class=\"fields-wrapper\"><div class=\"bn-row rowcb\"><span class=\"bn-label\">My name and personal information on this repory may be shared with other Paranormal Investigator, Teams, Groups and/or Organizations. </span> <span class=\"bn-input\"><span class=\"bn-optionwrapper\"><label class=\"bn-radio\"><input type=\"radio\" name=\"Field-167944721816690\" value=\"Yes, you  can share this information\" checked=\"checked\"> <span class=\"bn-inner-label\">Yes, you  can share this information</span></label></span><span class=\"bn-optionwrapper\"><label class=\"bn-radio\"><input type=\"radio\" name=\"Field-167944721816690\" value=\"No, please do not share this information\"> <span class=\"bn-inner-label\">No, please do not share this information</span></label></span><span class=\"bn-optionwrapper\"><label class=\"bn-radio\"><input type=\"radio\" name=\"Field-167944721816690\" value=\"Please contact me to share this information.\"> <span class=\"bn-inner-label\">Please contact me to share this information.</span></label></span></span></div></div><div class=\"fields-wrapper\"><label class=\"bn-row\"><span class=\"bn-label\">What is the best way to contact you? </span> <span class=\"bn-input\"><input type=\"text\" name=\"Field-167944562249197\" placeholder=\"\" validator=\"\" value=\"\"></span></label></div><div class=\"fields-wrapper\"><label class=\"bn-row\"><span class=\"bn-label\">Text Input </span> <span class=\"bn-input\"><input type=\"text\" name=\"Field-167944729134963\" placeholder=\"\" validator=\"\" value=\"\"></span></label></div><div class=\"fields-wrapper\"><label class=\"bn-row\"><span class=\"bn-label\">What is the best day and time to contact you about this report? </span> <span class=\"bn-input\"><input type=\"text\" name=\"Field-167944566051847\" placeholder=\"\" validator=\"\" value=\"\"></span></label></div><div class=\"fields-wrapper\"><div class=\"bn-row rowcb\"><span class=\"bn-label\">What type of Paranormal event did you experience? </span> <span class=\"bn-input\"><span class=\"bn-optionwrapper\"><label class=\"bn-radio\"><input type=\"radio\" name=\"Field-167944583260779\" value=\"UFO Sighting\" checked=\"checked\"> <span class=\"bn-inner-label\">UFO Sighting</span></label></span><span class=\"bn-optionwrapper\"><label class=\"bn-radio\"><input type=\"radio\" name=\"Field-167944583260779\" value=\"Alien Encounter\"> <span class=\"bn-inner-label\">Alien Encounter</span></label></span><span class=\"bn-optionwrapper\"><label class=\"bn-radio\"><input type=\"radio\" name=\"Field-167944583260779\" value=\"Alien Abduction\"> <span class=\"bn-inner-label\">Alien Abduction</span></label></span><span class=\"bn-optionwrapper\"><label class=\"bn-radio\"><input type=\"radio\" name=\"Field-167944583260779\" value=\"Ghost\"> <span class=\"bn-inner-label\">Ghost</span></label></span><span class=\"bn-optionwrapper\"><label class=\"bn-radio\"><input type=\"radio\" name=\"Field-167944583260779\" value=\"Haunting\"> <span class=\"bn-inner-label\">Haunting</span></label></span><span class=\"bn-optionwrapper\"><label class=\"bn-radio\"><input type=\"radio\" name=\"Field-167944583260779\" value=\"Poltergeist\"> <span class=\"bn-inner-label\">Poltergeist</span></label></span><span class=\"bn-optionwrapper\"><label class=\"bn-radio\"><input type=\"radio\" name=\"Field-167944583260779\" value=\"Demonic\"> <span class=\"bn-inner-label\">Demonic</span></label></span><span class=\"bn-optionwrapper\"><label class=\"bn-radio\"><input type=\"radio\" name=\"Field-167944583260779\" value=\"Sasquatch / Bigfoot\"> <span class=\"bn-inner-label\">Sasquatch / Bigfoot</span></label></span><span class=\"bn-optionwrapper\"><label class=\"bn-radio\"><input type=\"radio\" name=\"Field-167944583260779\" value=\"Cattle Mutilation\"> <span class=\"bn-inner-label\">Cattle Mutilation</span></label></span><span class=\"bn-optionwrapper\"><label class=\"bn-radio\"><input type=\"radio\" name=\"Field-167944583260779\" value=\"Other (please explain below)\"> <span class=\"bn-inner-label\">Other (please explain below)</span></label></span></span></div></div><div class=\"fields-wrapper\"><label class=\"bn-row\"><span class=\"bn-label\">What type of Paranormal experience did you have that is not listed above? </span> <span class=\"bn-input\"><input type=\"text\" name=\"Field-167944605453683\" placeholder=\"\" validator=\"\" value=\"\"></span></label></div><div class=\"fields-wrapper\"><label class=\"bn-row\"><span class=\"bn-label\">What was the date and time of your paranormal experience? </span> <span class=\"bn-input\"><input type=\"text\" name=\"Field-167944609180532\" placeholder=\"\" validator=\"\" value=\"\"></span></label></div><div class=\"fields-wrapper\"><label class=\"bn-row\"><span class=\"bn-label\">Where was your Paranormal experience? </span> <span class=\"bn-input\"><input type=\"text\" name=\"Field-1679446155676107\" placeholder=\"Example: Local library or Known Haunted location\" validator=\"\" value=\"\"></span></label></div><div class=\"fields-wrapper\"><label class=\"bn-row\"><span class=\"bn-label\">What was your age at the time of your Paranormal experience? </span> <span class=\"bn-input\"><input type=\"text\" name=\"Field-167944622852293\" placeholder=\"\" validator=\"\" value=\"\"></span></label></div><div class=\"fields-wrapper\"><label class=\"bn-row\"><span class=\"bn-label\">Was this your first Paranormal experience? </span> <span class=\"bn-input\"><input type=\"text\" name=\"Field-167944625673262\" placeholder=\"\" validator=\"\" value=\"\"></span></label></div><div class=\"fields-wrapper\"><label class=\"bn-row\"><span class=\"bn-label\">What were the weather conditions at the time of your experience? </span> <span class=\"bn-input\"><input type=\"text\" name=\"Field-167944628941989\" placeholder=\"\" validator=\"\" value=\"\"></span></label></div><div class=\"fields-wrapper\"><label class=\"bn-row\"><span class=\"bn-label\">If possible, please tell us the Solar/Lunar (moon phase) conditions at the time of your Paranormal experience. </span> <span class=\"bn-input\"><input type=\"text\" name=\"Field-167944635585528\" placeholder=\"\" validator=\"\" value=\"\"></span></label></div><div class=\"fields-wrapper\"><label class=\"bn-row\"><span class=\"bn-label\">Are there any witnesses present during your Paranormal experience, could you please provide their contact information? </span> <span class=\"bn-input\"><textarea name=\"Field-167944646514181\" placeholder=\"\" validator=\"\"></textarea></span></label></div><div class=\"fields-wrapper\"><label class=\"bn-row\"><span class=\"bn-label\">Was there the consumption of alcohol and or drugs (including legally prescribed medication) at the time of your Paranormal experiemce, and if so, please describe. </span> <span class=\"bn-input\"><textarea name=\"Field-167944658609193\" placeholder=\"\" validator=\"\"></textarea></span></label></div><div class=\"fields-wrapper\"><label class=\"bn-row\"><span class=\"bn-label\">At the time of your Paranormal experience, were you suffering from ant mental and/or medical issues, and if so, please describe. </span> <span class=\"bn-input\"><textarea name=\"Field-167944729134964\" placeholder=\"\" validator=\"\"></textarea></span></label></div><div class=\"fields-wrapper\"><label class=\"bn-row\"><span class=\"bn-label\">Please describe in as much detail as possible, your Paranormal experience, before and after you experience. If you require addition space, please include an attachment to this report at the appropriate place. </span> <span class=\"bn-input\"><textarea name=\"Field-167944740521171\" placeholder=\"\" validator=\"\"></textarea></span></label></div><div class=\"fields-wrapper\"><div class=\"bn-row rowcb\"><span class=\"bn-label\">Attachment </span> <span class=\"bn-input\"><input type=\"file\" name=\"userfile\" value=\"\"> <input type=\"hidden\" name=\"MAX_FILE_SIZE\" value=\"2097152\"></span></div></div><div class=\"fields-wrapper\"><div class=\"bn-row rowcb\"><span class=\"bn-label\">Is this the first time you are reporting your Paranormal experience? </span> <span class=\"bn-input\"><span class=\"bn-optionwrapper\"><label class=\"bn-radio\"><input type=\"radio\" name=\"Field-167944762940832\" value=\"Yes\" checked=\"checked\"> <span class=\"bn-inner-label\">Yes</span></label></span><span class=\"bn-optionwrapper\"><label class=\"bn-radio\"><input type=\"radio\" name=\"Field-167944762940832\" value=\"No\"> <span class=\"bn-inner-label\">No</span></label></span></span></div></div><div class=\"fields-wrapper\"><label class=\"bn-row\"><span class=\"bn-label\">If this is not the first time you have reported your Paranormal experience, can you please identify to whom and/or to where other reports were made? </span> <span class=\"bn-input\"><textarea name=\"Field-167944758959295\" placeholder=\"\" validator=\"\"></textarea></span></label></div><div class=\"fields-wrapper\"><label class=\"bn-row\"><span class=\"bn-label\">What is your reason for filing your Paranormal experience report with Paranormal StakeOut? </span> <span class=\"bn-input\"><input type=\"text\" name=\"Field-167944768459033\" placeholder=\"\" validator=\"\" value=\"\"></span></label></div>  <input type=\"hidden\" name=\"carboncopy\" value=\"ghostguy59@gmail.com\"> <input type=\"hidden\" name=\"thankyou\" value=\"http://www.paranormalstakeout.org\"> <input type=\"hidden\" name=\"thankyoutext\" value=\"\"> <input type=\"hidden\" name=\"subject\" value=\"A Paranormal Event Report Has Been Submitted\"><div class=\"bn-form-submit\"><button type=\"submit\" class=\"formbtn\">Submit Form</button></div> <style type=\"text/css\">.bnet-form ::-webkit-input-placeholder {');
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