Form XXXX Public Lesson Learned Submittal

U.S. Department of Transportation

Federal Aviation Administration

Office of Commercial Space Transportation, AST

800 Independence Ave., S.W. #331

Washington, DC 20591

Phone: (202) 493-5440 Fax: (202) 267-5463

Website: http://www.faa.gov/about/office_org/headquarters_offices/ast/

INFORMATION TO AID IN COMPLETING THE PUBLIC LESSONS LEARNED SUBMITTAL FORM

This form requires the completion of the following fields:

AUTHOR / POINT OF CONTACT: Provide the complete name, telephone number, email address, and company/organization of the author or point of contact (if different from the author). Please note that AST uses contact information in the event we need additional information to clarify the lesson learned. Although we will accept and make every attempt to validate anonymous submittals, the lessons learned submittals that we are unable to validate will be discarded. Unless granted permission otherwise, AST will not publically display your contact information.

TITLE OF LESSON LEARNED: The title should accurately reflect and summarize the subject of the lesson learned.

ABSTRACT: The abstract should be a concise summary of the lesson learned, preferably no more than a short paragraph or two in length.

TRIGGERING EVENT: Include a brief description of the event or problem which resulted in the lesson being learned.

LESSON LEARNED: Lessons learned are the knowledge or understanding gained through experience, which if shared, would benefit the work of others. Lessons may be positive, as in a successful mission or test. Lessons may also be negative, as in a mishap or failure. Sharing lessons learned promotes the recurrence of successful outcomes and precludes the recurrence of unsuccessful outcomes. Simply asking, “What worked well or what didn’t work so well?” is often the first step in identifying a lesson learned.

RECOMMENDATION(S): A recommendation is an endorsement, approval, or suggested course of action for implementing your lesson learned. A recommendation may include a procedural or regulatory change, corrective actions, etc.

TYPE OF ACTIVITY: Please select the type of operation to which this lesson applies. Note, this is a top level list and is not all inclusive. Please add any additional activities to the key word box.

ADDITIONAL AREA(S): Select the functional area(s) to which this lesson applies. Note, this is a top level list and is not all inclusive. Please include additional areas in the key word box.

KEY WORDS / PHRASES: Please include any key words or phrases for futures searches. Examples may include events leading to the discovery of the lesson such as pre-flight, launch, validation and verification, evaluation, etc.

COMMENTS & SUGGESTIONS: Please include any additional comments and suggestions.

INTENTIONALLY LEFT BLANK

PUBLIC LESSON LEARNED SUBMITTAL				Form Approved OMB No. 2120-XXXX Date:
FOR FAA USE ONLY
Date Received:		Lesson Learned Entry No.	EXT-
Author Information - Please note AST uses contact information in the event that we need to clarify your submittal. Unless granted permission otherwise, AST will not publically display your contact information.
Author:	     	Date:(mm/dd/yyyy)	     
Phone Number:	     	Email Address:	     
Company / Organization:		     
Point of Contact (if different from the author)
First Name:	     	Last Name:	     
Phone Number:	     	Email Address:	     
Company / Organization:		     
Title of Lesson Learned:
     
Abstract:
     
Triggering Event:
     
Lesson Learned:
     
Recommendation(s):
     

Type of Activity: Select the Activity to which this lesson applies. (Check all that apply)
	Amateur Rocket		Reentry Site
	Expendable Launch Vehicle (ELV)		Reusable Launch Vehicle (RLV)
	Launch Site		Safety Approval Element
	Reentry Vehicle (RV)		Other:      
Additional Areas: Select the Additional Area(s) to which this Lesson Learned applies. (Check all that apply)
Operations
	Flight Safety		Pre-Launch
	Ground Safety		Research and Development
	Ground Testing (Tether, static firing, etc.)		Quality / Product Assurance
	Launch		Weather (Crosswinds, lightning)
	Post-Launch		Other:      
Systems
	Electrical Systems		Recovery Hardware
	Environmental Control / Life Support		Safety-Critical Hardware
	Flight Controls (Electrical/Mechanical)		Safety-Critical Procedures
	Guidance, Navigation, and Control Systems		Safety-Critical Software
	Hydraulics and Pneumatics		Structures
	Operational Ordnance		Thermal Protection Systems
	Propulsion		Other:      
Regulatory / Legal
	Environmental Assessments		Other FAA (Airports, Air Traffic)
	Experimental Permit		Pre-Application Consultation
	Financial Responsibility		Safety Review and Approval
	License		State and Local Agencies
	Mishap Investigation		Waiver
	Other Gov. Agencies (NASA, DOD, EPA)		Other:      
Key Words / Phrases: Please include key words or phrases to aid in future searches. Examples include the phase of operation when the lesson was discovered, such as pre-flight, launch, etc.
     
Comments & Suggestions: Please provide any additional comments or suggestions.
     

Rev. 2-June 30, 2010