Shannon School of Aeronautics
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Instructors
Owen Travis
Sean Murray
Jim Henderson
Tarja Leach
Bruce Lichtman
Matt Gauvin
Cody Couch
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Aircraft
Cessna 172N
Cessna 172M
Cessna 152
Piper Warrior
Documents
Aircraft Documents
SSA SOP
SOP Quiz
Pilot Information Files
Rental Agreement
Safety
Risk Mitigation
Safety Reporting Form
NASA report form
Gallery
Contact Us
Home
Training
— Private Pilot Training
— Instrument Training
— Commercial Training
— Aircraft Checkout
— Medical Certificate
Costs
— Private Pilot Costs
— Instrument Rating Costs
— Commercial Costs
— Scholarship Opportunities
Instructors
— Instructors
—— Owen Travis
—— Sean Murray
—— Jim Henderson
—— Tarja Leach
—— Bruce Lichtman
—— Matt Gauvin
—— Cody Couch
— Instructors Applications
Aircraft
— Cessna 172N
— Cessna 172M
— Cessna 152
— Piper Warrior
Documents
— Aircraft Documents
— SSA SOP
— SOP Quiz
— Pilot Information Files
— Rental Agreement
Safety
— Risk Mitigation
— Safety Reporting Form
— NASA report form
Gallery
Contact Us
Safety Reporting Form
Personal Information and Incident
Personal Information and Incident
First Name
*
Email (Optional)
Last Name
*
Phone (Optional)
Role/Rating
*
Select
Student
Private
Private with Instrument
Commercial
CFI
CFII
None/Other
Aircraft Type
*
Date of Operation
*
Tail Number
*
Time of Operation
*
(HH:MM UTC)
Description
*
I have filed a NASA ASRS Form. (Link on "Safety" Page)
*
Yes
No
Weather
Weather
Conditions
*
Select
VFR
MVFR
IFR
Weather Not Applicable
Wind
Ex. 10G15 @ 240
Weather Comments/Other Conditions
Damage
Damage
Did any damage or injury result?
*
Yes
No
If yes, please describe:
Reflections
Reflections
What went wrong?
What went right?
How could we prevent this from happening again?
Were you under pressure to complete the operation?
Were you affected in any way by illness, medication, stress, fatigue or emotions?
Form Options
Confidential Report
I would like feedback on this report (email must be filled)
Send me a copy
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