Aviation Safety Report | Central Washington University

Safety Form

Central Aviation Safety Committee Aviation Safety Report Form.

First Name

Optional

Last Name

Optional

Submitter

Student

Flight Instructor

Dispatcher

Line Service

Maintenance

Faculty/Staff

Other

Field is required

Date of Incident

Field is required. Please enter a valid date.

(MM/DD/YYYY)

Time of Event

Please enter a valid timestamp

Ex: 4:00PM or 04:00 PM

Location

Field is required

Type of Event

Field is required

Phase of Flight

Tail Number

Describe Weather Conditions

Incident Description

Field is required

Remediation Recommendations

Optional

Phone Number

Please enter a valid phone number.

Please provide your contact information, if you give us consent to contact you regarding this report. - Optional

Field needs to be a valid email address.

Optional