Flight Safety Reporting System

  *Date:
 

*Time:
Day
Night

*Type of aircraft:
Cessna 172N
Cessna 172R
Cessna 172S
Cessna 182RG
Piper Arrow
Piper Seminole
Other aircraft involved (if applicable):


Type of flight (check all that apply):
Dual
Local
Training
Solo
Cross Country
Leisure

Route of flight:


*Location of incident:


*Describe the incident:
 

What factor(s) and/or situation(s) lead to this incident:


How could this incident have been prevented: