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November 4, 2016
Document Release Date: 
December 4, 1998
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PDF icon CIA-RDP96-00789R002100150061-6.pdf67.72 KB
I Approved For Release 2001/~03~107 : ~IA-RDP96-007898002100150061-6 GRILL FLAME VOLUNTEER CONSENT STATEMENT SGFOIA3 volunteer for INSCOM Project Grill Flame. I understand this program involves training designed to enhance inherent psychic abilities. I consent to this training and willingly volunteer to participate in INSCOM intelligence projects using my psychic abilities: I understand this program deals with mental perceptive abilities beyond the range of the five corporal senses _ -_..__ and 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 mental perceptive abilities and focus them on data beyond the range of the five corparal 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. NOTE: Physical examination taken within the past 12 months is acceptable. WITNESS VULULV'1't' Wit[ 7~ ~~ ~~i~ Approved For Release 20 ~~~31t~'T~'a;~G~A-RDP96-007898002100150061-6 ~, . , , i~ Approved For'Release 2001/03/07 :CIA-RDP96-007898002100150061-6 llA`l'A RE,~UIRLD BX `!SHE pF;I`iACY ACT Or' 197+ (5 U.S.C. 552a) :L . Autb.ority : Platianal Records Act , ~41E U . S . C . 3102 ; E . 0 . 9397 , Numiierin~; Syste~:r f'ar i~'ec~eral Accounts Relating to Individual Pe;?sons , November 22 , 1.9~}3. 2. Principal purpose: To maintain a record of those individus,ls rho have or h='~~~e h~~d u.~=cess to GRILL' FLAI'~ informration thrau~;h. the use of their na~rne end/ar ~ ~ci^1 Secu~~`ity P;umber. 3. Pontine Usea: mhe Social Security I7umbe.r is to be used to identify 'the individual, and. the information is to be retained strictly t~rithin the Program. 1~, r4anciatar;~ or VoJ_untary Discl.o:::ur.e: Information is disclosed on a volur.~tary basis>, but withholding,ian wi11. render it impossible to grant a.n ind.iviciual acce.> to or par in the Proz;ram. Approved For Release 2001/03/07 :CIA-RDP96-007898002100150061-6