BRITISH GLIDING ASSOCIATION BGA CLAIM FORM FOR UK 100KM DIPLOMAS PARTS 1 AND 2. Please complete 1 - 10 in clear block capitals using dark ink Payment - Please use the attached payment form. Current BGA fees are at www.gliding.co.uk/forms/bgafees.pdf. 1. APPLICANTS PERSONAL PARTICULARS FOR OFFICIAL USE ONLY Date Received Applicant’s BGA Reference Number ………………………………….................…………………………………….. Title………………………………………..Surname…………………………………………………………………………. Forenames………………………………………………………………….Nationality…………………………………….. Date of Birth………………………………Place of Birth……..…………………………………………………………….. Postal Address………………………………………………………………………………………………………………... ………………………………………………………………………………………………………………………………….. Post Code………………… …………Email Address………………………………………………………………………. Tel No…………………………………………….…Mobile No……………………………………………………………… Preferred contact method – phone, email or letter? ……………………………………………………………………… BGA Club/Air Cadet School and site………………………………………………………………………………………. Date of flight…………………………………………….. Place of launch …………………………………………………. Glider type ……………………………… Identification marks ………………………. Type of launch ………………….. Badge legs being claimed Part 1 [ ] 100km triangle or out and return Part 2 [ ] 100km triangle or out and return at faster than 65km/hr handicapped __2_._L__a_u__n__c_h___C__e_r_t_i_f_icate This must be completed for all claims. I certify that the above glider launched by winch/aerotow/self launch and released at (position)……………………………………………………………….. at (local time)…………………………………………………………. at an altitude of ………………………………………. ft/meters above airfield level. O/O or tug pilots name ……………………………………………………… Signature ……………………………………………………………….. 3.Landing Certificate This must be completed for all claims I certify that this glider landed at (exact position)........................................................................at (local time)..................................................... Name....................................................................... O.O No................................................................................................... Address if not an O.O............................................................................................................................................................................................. Name 2...................................................................................... Address ................................................................................................................................................................................................................. 4.Start time This must be completed for part 2 claims The start time determined by flight recorder evidence was ………………….. Official observer signature.................................................................. O.O. No....................... 5.Finish time This must be completed for part 2 claims The start time determined by flight recorder evidence was ………………….. Official observer signature.................................................................. O.O. No....................... 6.Distance This must be completed for all claims I certify that the official distance flown, via pre-declared turning points was .....................km. Official observer signature........................................................................................................................... No............................................................. O.O. 7.Difference in Height This must be completed for all claims The height loss between start and finish should not exceed 1000metres. The distance flown will be reduced by 100 times the excess over 1000metres. The BGA may call for a calibration chart where there is any doubt regarding the difference in height. I certify that the start altitude was ..................... (ft, metres), the finish altitude was ....................(ft, metres) and the difference in height is less than 1000metres or the the distance penalty is ....................km. Official observer signature.................................................................................................. O.O. No.............................................................. 8.Flight recorder evidence This must be completed for all claims. I certify that I supervised the removal and downloading of (type) ……………………….. flight recorder serial no ……………....... . The data is saved as file name .................................................................. and I am confident that it relates to the flight in question. Official observer signature.............................................................................. O.O. No..................................................... 9.Handicapped speed This must be completed for all part 2 claims. Note:- The glider’s speed index may be found from the table in the back of the current BGA Competition Handbook. Elapsed time for the course was ..................... calculated as the difference between Start time (section 4) and Finish time (section 5 ). Handicapped speed = distance in km x 60 x 100 (elapsed time in minutes x glider speed index = ...............................km/hr Official observer signature.............................................................................. O.O. No..................................................... 10.Official Observers Certificate This must be completed for all claims to prevent careless and time wasting claims. Accepting the separate certificates of Official observers and witnesses where appropriate, I have examined all the evidence relating to this flight and am satisfied that the flight qualifies for the award of 100km diploma part(s)........................................................................................ Official observer signature............................................................................. O.O. No........................................................... 11.Pilot’s Claim This must be completed for all claims I certify that I carried out the flight described above and that all the evidence is genuine. I request the BGA to approve the claim. Signature........................................................................................................ Date...................................................................................... Notes 1. A declaration is required for all 100km diploma flights. It must be completed before take off. The declaration may be on the flight recorder or sheet of paper signed by an OO. A sample paper declaration is available at www.gliding.co.uk/forms/declaration.pdf. 2. When the declaration is on the flight recorder, every effort should be made to ensure the pilot and glider details are correct. 3. Flight recorder evidence may be submitted on a floppy disk, CD ,full size SD card or USB data storage stick. Paper printouts of flight recorder files are not acceptable evidence. 4. Your claim should include this form, the declaration, flight recorder data, your gliding certificate and/or licence and the correct fee. PAYMENT All fees are payable in advance with the application Cheques must be payable to ‘The British Gliding Association’ If paying by cheque, please enter the amount here £ ____________________ If paying by credit or debit card, please complete the following: Card Holders Name (in full) Amount in £ sterling £ Card No Expiry Date __ __ / __ __ Valid From __ __ / __ __ Card Security No. (last 3 numbers) Address of Cardholder if different from applicant Postcode: