Nar High Power Certification Application
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1
2
3NAR HIGH POWER CERTIFICATION APPLICATION
APPLICANT INFORMATION
(Completed by applicant)
Name: _________________________________________________________
Birth Date _____/_____/_________
First
Last
Address: _______________________________________________________
NAR No.: ____________________
Street
Apt.
_______________________________________________________
Expiration Date: ______________
City
State
Zip
Is membership current?
Evening phone no.: (_____)_______________________
Cell phone no.: (_____)_______________________
(Optional)
I,
___________________________________________,
certify
that
I
am a
member
in
good standing of the
National
Association of
Rocketry. I
am
18
years of age or older. I understand that I must
comply with
all
applicable
federal,
state,
and
local
laws or
regulations
during
and after
this certification
attempt.
Signed:____________________________________________,
Date:____________,
Location:__________________
HPR LEVEL 1 CERTIFICATION CHECKLIST
(Certification Team - Use this section Only for HPR Level 1 Certification Attempts)
Preflight:
Motor(s) used: _________________________ (At least one motor must be an H or I Impulse Motor)
Motor is certified
FAA Waiver available
Safety checklist complete
(if required)
(see back)
Flight:
Model is stable
Recovery system deployed
Safe recovery
Post Flight:
Verify that no major damage is Present Minor impact damage or "zipper" is acceptable
Verify motor(s) is (are) present
Yes
No
Successful flight?
HPR LEVEL 2 CERTIFICATION CHECKLIST
(Certification Team - Use this section Only for HPR Level 2 Certification Attempts)
Preflight:
Motor(s) used: _________________________ (At least one motor must be an J, K or L Impulse Motor)
Motor is certified
FAA Waiver available
Safety checklist complete
(if required)
(see back)
Applicant is Level 1 certified
Level 2 Written Exam passed within one year on____/____/____
Month
Day
Year
Flight:
Model is stable
Recovery system deployed
Safety recovery
Post Flight:
Verify that no major damage is Present Minor impact damage or "zipper" is acceptable
Verify motor(s) is (are) present
Yes
No
Successful flight?
CERTIFICATION AFFIDAVIT
(Successful attempts only, completed by certification team)
We, the undersigned, being members of the National Association of Rocketry distinct from the applicant, have
witnessed a demonstration by
___________________________________
_________, of skills relative to the
(Name)
(NAR#)
building and safe operation of High Power Rockets. We attest that the applicant is 18 years of age or older and a
member in good standing of the NAR. We believe this member is qualified to build and operate High Power rockets
with a total installed impulse up to:
640 N-sec. (Level 1)
5120 N-sec. (Level 2)
Name (Printed): ____________________________
Signature: ___________________________
NAR No: ____________
Birth Date: _____/_____/___________
Membership Expiration Date: _____/_____/___________
Certification Level: _____
Name (Printed): ____________________________
Signature: ___________________________
NAR No: ____________
Birth Date: _____/_____/___________
Membership Expiration Date: _____/_____/___________
Certification Level: _____
Cut Along Dotted Line
NAR HIGH POWER CERTIFICATION
1)
Request
individual Level
2
Written
Exams
from
NAR
HQ
Name (Printed): ____________________________
PO Box 407
NAR No.: _____________
Cert Level:
“1”
“2”
Marion, IA
52302
Certification
Teams
or
Section
Leaders wishing to
obtain
multiple copies
of
Certification Date: _______/_______/___________
the
of
the
Level
2
Written
Exams
can send an
email
to the
current
NAR
Chairman
of
Sport
Services
listed
on
the
NAR
Website
for
a
soft
copy
of
Witnessed By: _____________________________
the files
Witnessed By: _____________________________
2)
Send
completed
forms
(with
exams,
if
applicable) to the
NAR
HQ address
listed
above
Revision
2-Oct-2010, File
- hpappl
This card is void 60 days after Certification Date
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