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November 4, 2016
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December 4, 1998
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PDF icon CIA-RDP96-00789R002100150074-2.pdf64.78 KB
,, Approved For Release 2001/03/07 : CIA~RDP96-007898002100150074-2 GRILL FLAME VOLUNTEER CONSENT STATEMENT SGFOIA3 I , ;J"vSE P H ~ ~ M.c-M ~~V E-AG LE NAME ~ '. volunteex? 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 tiow to discipline my mental 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 EKCx prior to beginning training. NOTE: Physical examination taken within the past 12 months is acceptable. WITNESS ~/~ h ~..... Approved For~Release ~~~:1~0~~/m7~ CIA-RDP96-007898002100150074-2 ,~ , '~~ ~.ti:'? .,., s ~ , ~-:~ Approved For Release 2001/03/07 :CIA-RDP96-007898002100150074-2 T)A`1'1~ hT~~GZUlRLI) BY '!'TIT?, 1'1? C~r11CY ACT Ol'' l~'~~+ (5 U.S.C. j52a) 1. 1!utT;.ority : i,ational Records pct , 1+1F U . S . C . 3102 ; 1;. 0. 9397 , Nwnberinfr Syste::: fc.r i~'ec;.era1 1lccounts Relating; to Individual Pei?sons, IVTovember 2?_, ].9143. 2. Principal Purpose: To ma:irtain a record of those individuals z?rho have or h;~,~re h+~,d s.ccess to GRILL' 1iLltP~TE informr;~t_ion through the use of their Warne and/or E',cci 1 Secu-!~ii;y I`Turnber. 3. Rcuti..e Uses: The Social Security T~dumbe.r is to be used to identify the individua_1, and the information is to be retained strictly within the Program. +. r~iandc.tory or Vol.u.:ztary Discl.osur. e : Information is disclosed on a volur~tury bavis, but withholding informa~t,ion i~ri1.J. rf:nder it impossible to grant a.n individual access to or par~tic9.pation in the Program. Approved For Release 2001/03/07 :CIA-RDP96-007898002100150074-2