m/dd
(flt date)

 aircraft flight request / flight schedule	aircraft information	
	FAA #
     	
INITIAL REQUEST INFORMATION	CHARGE CODE

      				
DATE
     	TO
     		 POINT TO POINT	 HELICOPTER	FLIGHT SCHEDULE NUMBER
     	
						
TIME
      	FROM
      		  MISSION FLIGHT	  FIXED WING	MAKE/MODEL

MISSION DETAILS   
         	COLOR
     	
		
	VENDOR
     	
PASSENGER and CARGO INFORMATION		
NAME / CARGO TYPE	WT	ORDER #	DPT	DST	NAME / CARGO TYPE	WT	ORDER #	DPT	DST	TELEPHONE
     
	
     	     	     	     	     	     	     	     	     	     		
     	     	     	     	     	     	     	     	     	     		
     	     	     	     	     	     	     	     	     	     	PILOTS
     	
     	     	     	     	     	     	     	     	     	     		
     	     	     	     	     	     	     	     	     	     		
FLIGHT ITINERARY	
DEPARTURE	ETE	ARRIVAL	drop off	KEY POINTS	RELAYED	
DATE	PAX	WT	AIRPORT	ETD	ATD		AIRPORT	ETA	ATA	PAX	CARGO		to/from	
     	     	     	     	     	     	     	     	     	     	     	     	     	     	
     	     	     	     	     	     	     	     	     	     	     	     	     	     	
     	     	     	     	     	     	     	     	     	     	     	     	     	     	
     	     	     	     	     	     	     	     	     	     	     	     	     	     	
     	     	     	     	     	     	     	     	     	     	     	     	     	     	
FLIGHT FOLLOWING	RADIO FREQUENCIES	
  FAA Flight Plan Filed

 Agency Flight Following	UNIT	TRANSMIT	RECEIVE	
		Frequency	Tone	Frequency	Tone	
	     	     	     	     	     	
	     	     	     	     	     	
	     	     	     	     	     	
National interagency Coordination Center Flight Following: 800-994-6312
Northern Rockies Coordination Center:406-329-4880;  Duty Officer: 406-544-2632	NOTES