Digital Junior Level 1 HPR Certification Form

    The NAR JUNIOR HPR PARTICIPATION PROGRAM APPLICATION Form is used to fill out the following digital form. Your answers will be checked with both the paper Junior HPR Certification Form and with your HPR certification team member. A picture of your paper HPR Certification Form must be attached to this form to considered a valid submission. The answers you give on this form must match the answers of your paper HPR Certification Form.

    APPLICANT INFORMATION

    (Completed by Applicant and Adult Guardian.)

    Applicant Name

    Address

    City

    State

    Zip Code

    Birth Date (Month/Day/Year)

    Phone

    Email Address

    NAR Number

    Membership Expiration Date (Month/Day/Year)

    I certify that I am a member in good standing of the National Association of Rocketry. I am 14 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.

    Applicant—I certify the above is true and correct:
    I AcceptI Decline

    Legal Guardian—I certify the above is true and correct:
    I AcceptI Decline

    Date (Month/Day/Year)

    FLIER INFORMATION

    (Completed by Flier of Record.)

    NAR Certified Flier of Record

    NAR Number

    HPR Cert. Level

    JUNIOR CERTIFICATION HPR LEVEL 1 CHECKLIST

    Preflight:
    Junior HPR Level 1 Written Exam passed (within one year) on (Month/Day/Year):

    Motor Used (At least one motor must be a H or I impulse motor.)

    Motor is certified.
    YesNo


    FAA COA Activated.
    YesNot Required


    Safety checklist completed (Located on back of paper form).
    YesNo

    Flight:

    Flight was stable
    YesNo


    Recovery system deployed
    YesNo


    Safe recovery
    YesNo

    Post Flight:

    Verify that no major damage is present. Minor impact damage or "zipper" is acceptable.
    YesNo


    Verify motor present
    YesNo


    Successful Flight?
    YesNo

    CERTIFICATION AFFIDAVIT

    APPLICANT NOTE: Your certification member will be contacted to confirm your Junior Level 1 status.

    CERTIFICATION TEAM MEMBER(S)

    APPLICANT NOTE: Your certification team member(s) will be contacted to confirm your Junior Level 1 status.

    Name 1


    NAR #


    Membership Expires (Month/Day/Year)


    HPR Cert. Level


    Email address

    NOTE: For those certifications signed off by a single Level 2 or Level 3 Certification Team member, enter "N/A" into all of the second Certification Team member fields.

    Name 2


    NAR #


    Membership Expires (Month/Day/Year)


    HPR Cert. Level


    Email address

    NAR JUNIOR HPR PARTICIPATION PROGRAM APPLICATION (SIDE 1)
    (Your HPR Certification Form that was filled out the day of your flight must be attached here.)

    NAR JUNIOR HPR PARTICIPATION PROGRAM APPLICATION (SIDE 2)

    NAR JUNIOR HPR LEVEL 1 EXAM ANSWER SHEET