GRILL FLAME VOLUNTEER CONSENT STATEMENT (MAURICE C. HIMES)

• Document Type: CREST
• Collection: STARGATE
• Document Number (FOIA) /ESDN (CREST): CIA-RDP96-00789R002100150068-9
• Release Decision: RIPPUB
• Original Classification: S
• Document Page Count: 2
• Document Creation Date: November 4, 2016
• Document Release Date: December 4, 1998
• Sequence Number: 68
• Content Type: CONT

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Approved For Release 2001/0~~07 :CIA-~DP96-007898002100150068-9
GRILL FLAME VOLi7NTEER CONSENT STATEMENT S G F OIA3
NAME
N
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 Yiow 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 EKG prior to beginning training.
NOTE: Physical examination taken within the past 12 months is acceptable.
Approved For Release 200 :f~31d.`~~`~~ ~ -RDP96-007898002100150068-9
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 Approved For Release 2001/03/07 :CIA-RDP96-007898002100150068-9
1)A~.1'A RJsG~UlRI?I) BY TTTF PRT~I)`,CY 11C'I' Ol'' 197+
(5 U.S.C. 552x)
1. ~!uth.ority : PTatioi:al Records pct , 1ElF U . S . C . 3102_ ; I;. U . 939'7 , Numbering
Systerri fo.~ Federal Ilccounts Relating to Individual Pei?sans, I~Tovember 22, 1.9~F3.
2. Principal Purpose: To rr~aintain a record of those individuals who have
or have had access to GI?ILL' FLl1T~ inform~.~tion through the use of their name
and/or Socwc.l Security PJumUer.
3. T?outine Uses : The Social Security Tlumbe.r i.s to be used to identify the
individual, and. the information is to be retained strictly within 'the Program.
~+. t4anda.tory or Voluntary I)iscl.osure: Information is disclosed on a
vol~..ntary basis, but withholczirig information wi1.1. render it impossible to
grant ~.n ind.ividual access to or par tici~ation in the P.rog,.ra.rn.
Approved For Release 2001/03/07 :CIA-RDP96-007898002100150068-9