Tripoli Research Altitude Record Form

Name__________________________________ Tripoli # ___________________________

Address________________________________ Area Code _____ Phone # ____________

City, State, ZIP_____________________________________________________________

EMail Address__________________________________________

Altitude Achieved_________________________ Date ______________________________

Record Class (Circle appropriate motor class)

     24mm      any      E
     29mm      any      F, G, H
     38mm      Under 12"      I
     38mm      Over 12"      J
     54mm      Under 12"      J
     54mm      12" - 24"      K
     54mm      Over 24"      L
     75mm      Under 26"      L
     75mm      Over 26"      M
     98mm      Under 29"      M
     98mm      29" - 48"      N
     98mm      Over 48"      O
     5"      any      O, P
     6"      Under 80"      P
     6"      Over 80"      Q

Launch Information:

Name of Launch _________________________ Launch Organizer ___________________

Date of Launch __________________________ Place of Launch ____________________

Elevation Above Sea Level _________________ Temperature at Launch _______________

Mass Rocket: Gross ___________________ Empty _______________________

Total Rocket Length: ___________________

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 #1________________________________

Model___________________________

   Manufacturer #2________________________________

Model________________________

Reported Accuracy_______________

Date of Purchase_______________ Flown Altimeter Before? ( Y / N )

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

VERIFICATIONS

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 official #2 can be any Tripoli member who observed the preparation and launch of the rocket. The applicant must be a current Tripoli member. Both must validate altitude.

Launch Official #1 – PREFECT AT SITE

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. Dr.

San Jose, Ca.  95120

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