Operator Information

Full Name*

Full Address (include street or mailing, city, state, zipcode)*

Phone Number*

Email*

UAS Information

Type (e.g. fixed wing/multi-rotor)*

Weight*

Shape*

Color*

Payload*

Registration Number (if over .55 lbs) - Must be marked on outside and operator must carry proof of*

UAS Safety Test (TRUST) Completion Date - Operator must carry proof of*

Activity Requesting

Date of Launching/Landing*

Timeframe*

Predicted Wind and Visibility Forecasted*

Purpose (hobby/recreational/monetary purposes)*