LifeFlight / Education & Outreach / Operation Tail Watch Request Form

Operation Tail Watch Request Form

 
Requestor
First Name:
Last Name:
Email:
Phone:
Point of Contact
(Omit if Requestor)
First Name:
Last Name:
Email:
Phone:

Organization or Agency requesting Tail Watch Visit:
Dept. or Unit
City
State
Tail Watch Visit Information
Preferred Month or Date(s)
Preferred Time
Number Attending
Location:
If another event will be taking place at the same time as the Tail Watch Visit please briefly describe the other event (e.g. monthly training, etc.):
The following information is required if a Fly-In is requested.
Fly-In? Yes No
LZ Info (include Lat/Long coords if possible):
 
LZ Contact/Unit:
Lat:
LZ Radio Frequency
(if other than 155.205):
Long:
Remarks:

 

Please press submit only once.