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Document Creation Date: 
November 4, 2016
Document Release Date: 
December 4, 1998
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PDF icon CIA-RDP96-00789R002100150050-8.pdf63.45 KB
~ ~ '- . ~;,~,, . Approved For Release 200'4-f0~107 : C~A-RDP96-007898002100150050-8 GRILL FLAME VOLUNTEER CONSENT STATEMENT I ~ ~nFCv~n~ c': ~~~_ y SGFOIA3 volunteer f'or INSCOM Project Grill Flame. I understand this program involves graining designed to enhance inherent psychic abilities. I consent to this graining and willingly volunteer to INSCOM intelligence projects using my psychic abilities. I understand this program deals with mE~ntal perceptive abilities beyond the range of the five corporal senses arrd for this reason an aspect of mental training is involved. I understand that the purpose of this training is to teach me how to discipline my merntal perceptive abilities and focus them on data beyond the range of the five corporal senses. I understand that as a volunteer I may withdraw from the program at any time for any reason. My decision to withdraw from the program will be accepted without controversy. I understand that for precautionary and screening reasons that I as a GRILL FLAME volunteer must have a Class A physical exam to include a stress EKG prior to beginning training. NO~PE: Physical examination taken within the past 12 months is acceptable. WITNESS ~~~~ VOLUNTEER i~ ~~ C ,1~.~ Approved For Releas~Y~0,0''I`/I~t~7 : CIA-RDP96-007898002100150050-8 Approved For Release 2001/03/07 :CIA-RDP96-007898002100150050-8 llA7:'Jl l;F,RUTRI,I) BY ~'HE Pt3IVi CY ACT OI'' 1974 (5 U.S.C. 552a) 1. Auth.o.rity: TTa~t:tonal Records Ac-t, !r!F U.S.C. 3102; 1;.0. 9~3y7, Nu.mlaering System for F'eder~,l Accounts Rcl.ating to Individual Persons, November 2?, 1.943. 2. Pr i nc ipal P~.x?T~ose: To maintain a record of those individuals ti~ho have or gave r;'.~d J,ecess to GRILL' FLAPS in.forinration through the use of their name and/or ~'ocil Secu~!-it;~r P1ur.:bcr. 3. Routine U:~es: The Social Security Tdumbe.r is to be used to identify- the individual, and the information is to be retained st.rirtly z~rithin the Program. 1+, r4andat,ory or Voluntary Discl.osur. e : In.formati.on is disclosed on a ?voluratarjr bavi,^,, but withholding information wi~.l. render it impossible to ,rant a.n individual access to or,tion in the Prog.ra.tti. Approved For Release 2001/03/07 :CIA-RDP96-007898002100150050-8