School Program Public Safety Program

Please fill out the form below completely. A representative from NorthSTAR will contact you.

Requesting Agency Name:
Requesting Agency Telephone:
Requesting Agency Address:
Contact Person Name:
Contact Person Rank/Position:
Contact Person Telephone:
Contact Person Address:
Contact Person Email:
Date(s) / Time(s) Requested*:
Type of Request:
Other Participating Agencies:
Estimated Total Attendance:
Classroom Location (Facility Name / Address):
LZ Location (Include the name of the location & the intersection of the two closest streets):
Latitude & Longitude; closest intersecting roadways
to LZ; frequencies including options of duplex dual frequecy,
simplex or single frequency, or PL (private line tones):

NOTE: If aircraft is requested, LZ must be government, municipal, county, or state property, or an approved helipad. Otherwise, a copy of the owner's insurance rider must be received by NorthSTAR. For example, if landing at a school, the Board of Education must provide a copy of the insurance rider. (This requirement applies ONLY to demonstrations, not actual medevac flights.)

* 60 Days of Notice is Necessary in order to have lecturer available.

The LZ must be 110 feet square, level, firm, and free of debris. No overhead obstructions such as power lines, large trees, cranes, etc can be present. The LZ must be physically secured by emergency apparatus and personnel.

Please be patient, allow a few moments for the form to be submitted.