Unmanned aircraft systems request form

Unmanned aircraft systems

request form

Prior to flying or operating an unmanned aircraft system on or above Arizona State University property, an unmanned aircraft systems request form must be completed.

Whether the request is approved or denied, a member of ASU's Risk and Emergency Management will be in touch.

For more information and valuable resources please visit

Unmanned Aircraft Systems.

Are you an ASU student, faculty, or staff?*

Yes

If NO, Please provide ASU Contact Info*

Please provide the name, email address, and phone number of your ASU contact.

Is this part of your University employment, ASU activities, or a Special Event?*

Yes

Will you be using ASU funding to purchase a UAS?*

This includes university accounts, grants, or ASU foundation funding

Yes

Will you be using an unmanned aircraft system owned by ASU Business & Finance?*

Yes

Will you be hiring a third party to provide UAS services?*

Yes

Requestor Information

Department*

You can search for your department in the dropdown menu.

IF YOU DO NOT SEE YOUR DEPARTMENT IN THE DROPDOWN, TYPE IN YOUR DEPARTMENT'S FULL OFFICIAL NAME AND PRESS "ENTER"

Select or enter value

Location (s) of activity*

Flight Path*

Provide a brief description of the flight path here. A diagram of the flight path will be required under the supporting documents section.

Will you be operating a UAS on or above university property?*

Yes

Does the flight path go over any Non-ASU property?*

Yes

Have you obtained property owner permission?*

Yes

Does the flight path take place at or go over any Sun Devil Athletic Facilities?*

Yes

Have you obtained permission from Sun Devil Athletics?*

When operating on or over Sun Devil Athletics Facilities special permissions are required from SDA leadership. **Please attach the permission letter in the supporting documents section below.

Yes

Emergency Contact Info

Emergency Contact Name*

Emergency Contact Address*

Emergency Contact Phone Number*

Phone

Emergency Contact Relationship*

Notice: UAS owned by ASU Business & Finance

If you are using a UAS owned by ASU B&F and you do not have the FAA Certificate#, Serial #, of Manufacturer/Model, please put "Not Available" in these sections.

DRONE #1 INFORMATION

Drone (1) FAA certificate number*

Drone (1) Serial Number*

D1 Manufacturer and Model*

Drone (1) List of equipment*

Drone (1) Weight and payload*

Is Drone (1) owned by ASU?*

Select

Drone (1) Owner contact info*

Will there be a second drone?*

Yes

DRONE #2 INFORMATION

Drone (2) FAA certificate number*

Drone (2) Serial number*

Drone (2) Manufacturer and Model*

Drone (2) List of equipment*

Drone (2) Weight and payload*

Is Drone (2) owned by ASU?*

Select

Drone (2) Owner contact info*

Will there be a third drone?*

Yes

DRONE #3 INFORMATION

Drone (3) FAA certificate number*

Drone (3) Serial number*

Drone (3) Manufacturer and Model*

Drone (3) List of equipment*

Drone (3) Weight and payload*

Is Drone (3) owned by ASU?*

Select or enter value

Drone (3) Owner contact info*

Will there be more than three drones?

Select

PILOT #1 INFORMATION

Pilot (1) License and rating*

Pilot (1) Describe UAV training*

Is the Pilot (1) an ASU employee?*

Yes

Has ASU completed an agreement with Pilot (1) for these services?*

Yes

Will there be more than one pilot?*

Yes

PILOT #2 INFORMATION

Pilot (2) License and rating*

Pilot (2) Describe training*

Is Pilot (2) an ASU employee?*

Yes

Has ASU completed an agreement Pilot (2) for these services?*

Yes

Will there be a third pilot?*

Yes

PILOT #3 INFORMATION

Pilot (3) License and rating

Pilot (3) Describe training

Is Pilot (3) an ASU employee?

Yes

Has ASU completed an agreement with Pilot (3) for these services?*

Yes

Will there be more than three pilots?

If the answer is yes, please provide the answers to the above questions for all additional pilots in a document and attach it in supporting documents.

Yes

Including without limitation to the regulations noted below

I warrant that the above use of UAV's complies with all FAA regulations.*

All Pilots are authorized to operate the UAV's under:*

Section 333 exemption

Section 336 exemption

Part 107 exemption

Other

Please describe below

Will any of the pilots receive compensation either directly or incidentally as a result of that person't operation of the UAVs?*

Yes

Has a Certificate of Authorization been obtained for the specific UAV activity?*

Yes

Is the flight path described in Class G Airspace?*

Yes

Has special permission been obtained for the use of the airspace?*

Yes

Is the flight path within five miles of an airport?*

Yes

Has the airport been notified of the flight path?*

Yes

Will the UAVs be continuously operated by the pilots and be within the sight of the pilots at all times?*

Yes

Will the UAV operate in any of the following conditions:*

Please select all that apply

Has an FAA waiver been obtained?*

Yes

Filming

When filming with a UAS on or of university property, please visit ASU's Enterprise Brand and Marketing Guide for proper photography and videography guidelines.

Will the UAVs have a camera attached to it during any use?*

Yes

Will any video or pictures be taken of any individuals?*

Yes

Has an ASU Photo Subjection Release Form been completed?*

See resources at ASU Brand Guide for Photo Release.

Yes

Risk Management Documentation

Supporting Documents*

Upload all required documentation here.

Pilot certificate - Both the front and back of your UAS pilot license
Flight Path diagram
All applicable property permission letters
Certificate of Insurance (Non-ASU Affiliates Only)
Release, Indemnity and Assumption of Risk Agreement (Non-ASU Affiliates Only)

Release, Indemnity and Assumption of Risk Agreement

Drag and drop files here or

Acknowledgement and Agreement

Any violations of FAA or university policies will be dealt with in accordance with applicable university policies and procedures.

Legal prohibitions regarding physical presence on campus or trespassing and other legal action may also be pursued against third parties that operate UAS in violation of this policy.

Fines of damages incurred by individuals or units that do not comply with this policy will not be paid by ASU and will be the responsibility of those persons involved.

Unmanned Aircraft Systems

I acknowledge I have read the ASU unmanned aircraft systems policy.*

I understand that if my request is accepted, any false statements, omissions, or other misrepresentations made by me on this request form may result in my immediate dismissal.

I understand and affirm that all the facts outlined in this form are true and complete.*

Send me a copy of my responses

Scope of Request

Requestor Information

Flight Information

Emergency Contact Info

Notice: UAS owned by ASU Business & Finance

Drone Information

Pilot Information

FAA Compliance

Filming

Risk Management Documentation

Acknowledgement and Agreement