UAS (Drones) Flight Request

Please submit a minimum of 72 hours prior to proposed flight. You may use this form for single flights or multiple flights related to the same recreational use / project parameters.
Your Full Name Your Full Name First Last
Department / or Company
Your Contact Phone
Your Email
FAA Authorization (Provide a copy of your authorization. e.g., FAA Pilot's License, Section 333 Exemption, Part 107)

Attach Files
Certificate of Insurance (Note: Required for non-UC applicants only. Provide a copy of your insurance coverage with UCSD listed as additionally insured during UAS flight operation dates.)

Attach Files
Pilot Name Pilot Name First Middle Last
Pilot's License #
Pilot 2 Name Pilot 2 Name First Middle Last
Pilot's License #
Pilot 3 Name Pilot 3 Name First Middle Last
Pilot's License #
Other Pilots

If additional pilots are to be used, list their name followed by their Certificate Number e.g., Tom Jones AA12345; Patsy Kline AA56789
Aircraft(s) Make/Model

Please list all makes/models to be used if using multiple UAS.
Aircraft(s) Owner

Please list all aircraft owners. If different owners, specify each next to aircraft.
FAA Aircraft Registration Number(s):

Please list all FAA aircraft registration numbers
Select if the aircraft is owned by the University of California Please enter owner(s) if not UC-owned Please enter owner(s) if not UC-owned
Additional information about aircraft (optional)

If multiple aircraft, list additional aircraft by their description and registration number (if applicable)
Purpose of Flight (choose all that apply)

Purpose of Flight (choose all that apply) Class Assignment Club Activity Building Inspection Filming for the University Filming for Student Club Aerospace Research Agricultural Monitoring/Research Environmental Monitoring/Research Other Other
Will You Be Flying over People?
Is this a Scripps Institution of Oceanography (SIO) venue event (wedding, conference, etc.) happening on SIO property?
If this is a Is this a Scripps Institution of Oceanography (SIO) venue event, please specifiy the event name: (example, "Smith wedding", NVDIA dinner, etc.)
Proposed Flight Date Proposed Flight Date / MM / DD YYYY
Proposed Flight Time Proposed Flight Time : HH MM AM/PM
Flight Duration Time (please estimate in minutes or hours)
Flight Altitude (please use feet)
(Use this GPS resource link to find the flight point of origin and use this the Know Before You Fly FAA site to find prohibited areas, temporary flight restrictions and more.)
Flight Details (for multiple flights)
e.g., Flight 1: Syma X5C, (20 minutes) 8 a.m.-8:20 a.m., 400 feet, December 12, 2016 Flight 2: DJI Phantom 4 (30 minutes), 10 a.m.-10:30 a.m., 600 feet, December 12-15, 2016 (daily)
Provide information about the flight(s). If there are going to be multiple flights, please provide detailed information e.g., drone type used, flight times, each flight duration, altitudes, daily or weekly flight times, etc.
Latitude and Longitude (please use decimal degrees)
Map of Flight Operations or General Description of Flight Operational Area

Attach Files

Please include a map of the area including flight paths and altitudes.
Scope of Flight (Please add all locations/coordinates if multiple flights)
Operating Procedures/Other Notes

Please add any information as relevant to the authorization or approval of the flight request.
Acknowledgement

Acknowledgement I acknowledge that the review of UAS safety does not absolve an RPIC's responsibility to ensure a safe operating environment and all UAS flights for official UC business or on UC owned property must be reported with the UCSD UAS Post-Flight Reporting Form. Fill out your Post-Flight Form here.
Spam Protection. Please answer this simple question:
The last letter in "tiger" is?