JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
Kortrijk Flying Club Safety Reporting
Incident / Occurance report
Sign in to Google
to save your progress.
Learn more
* Indicates required question
Email
*
Your email
Reporting date
MM
/
DD
/
YYYY
Filed by (optional)
Your answer
Date occurancy
*
MM
/
DD
/
YYYY
Country / Area
Your answer
Aerodrome
Your answer
Occurancy location
Hanger
Apron
Taxiway
Parking
Other
Clear selection
Aircraft registration
OO-CPO
OO-GTI
OO-FBI
OO-KGB
OO-GTX
OO-WAN
Clear selection
Operational information
Flight phase
Your answer
Occurancy on the ground
yes
No
Clear selection
Departure AD
Your answer
Take-off
Time
:
AM
PM
Arrival AD
Your answer
Landing
Time
:
AM
PM
Relevant weather
Wind
Your answer
Visibility
Your answer
Clouds
Your answer
Weather
Your answer
Narrative description
Your answer
Injury
Severity level
Fatal
Serious
Minor
None
Unknown
Clear selection
Highest damage to the aircraft
Destroyed
Substantial
Minor
None
Unknown
Clear selection
A copy of your responses will be emailed to the address you provided.
Submit
Clear form
Never submit passwords through Google Forms.
reCAPTCHA
Privacy
Terms
This content is neither created nor endorsed by Google.
Report Abuse
-
Terms of Service
-
Privacy Policy
Forms
