Tripoli Altitude Record Form

Name__________________________________ Tripoli # ___________________________

Address________________________________ Area Code _____ Phone # ____________

City, State, ZIP_____________________________________________________________

EMail Address__________________________________________

Altitude Achieved_________________________ Date ______________________________

 

Record Class (Check appropriate motor class)

___F ___G ___H ___I ___J ___K ___L ___M ___N ___O

 

Launch Site Information:

Name of Launch _________________________ Launch Organizer ___________________

Date of Launch __________________________ Place of Launch ____________________

Elevation Above Sea Level _________________ Temperature at Launch _______________

 

List Motor(s) and Manufacturers

Motor	Total Impulse	# Used	Manufacturer	Date Code	Stage Number (1,2 etc.)

Total Impulse of all Motors _______________ N-SEC # of stages _________

Mass Rocket: Gross ___________________ Empty _______________________

Total Rocket Length: ___________________

Stage 1 Diameter: _______ Stage 2 Diameter: ________ Stage 3 Diameter:________

 

Method of Altitude Verification: ____ Optical Tracking ____Altimeter ____ Other

For optical tracking only: Baseline Length________
Tracker 1 Az____ Elev_____ Tracker 2 Az_____ Elev____
Reduction Method________________ Closure %_________________
Use separate sheet of paper to explain reduction method if necessary..

For altimeters only: Manufacturer________________________________
Model________________________ Reported Accuracy_______________
Date of Purchase_______________ Flown Altimeter Before? ( Y / N )

Other: Attach separate sheet of paper detailing equipment and method used.

Signatures:
The individual listed below certifies that the record attempt successfully deployed the recovery device(s) and had a safe descent.

RSO Name_______________________ TRA #________ Signature_________________ Date_________

The individuals listed below certify that the motors listed above were the ones used in the record attempt and the altitude obtained by optical tracking or an altimeter is accurate to the best of his/her knowledge. The witnesses or launch officials can be any Tripoli member who observed the preparation and launch of the rocket. The applicant must be a current Tripoli member.

Witness or Launch Official #1

Name _______________________ TRA #________ Signature __________________ Date___________

Witness or Launch Official #2

Name _______________________ TRA #________ Signature __________________ Date____________

Applicant

Name _______________________ TRA #________ Signature __________________ Date____________

 

Photograph of Rocket Included? ( Y / N ) Required for all official record attempts

Drawing with Dimensions Included? ( Y / N) Suggested, but not required.

 

A filing fee of $5.00 (make checks payable to "Tripoli") must be included with this form. Additional information may be requested concerning the record attempt before the flight is recognized as a record. Including a photograph of the rocket is required and a drawing or diagram is encouraged. This form should be postmarked no later than thirty days after the date of the record attempt and sent to the Tripoli Contest and Records Committee at the address below.

Tripoli Contest and Records Committee
Tom Rouse
7170 Wooded Lake Dr
San Jose Ca. 95120

 

(Copy this form, as many times as neccessary, for your use.)