DD Form 1721-1 "Space Test Program Flight Request Executive Summary"

What Is DD Form 1721-1?

This is a form that was released by the U.S. Department of Defense (DoD) on September 1, 2006. The form, often mistakenly referred to as the DA Form 1721-1, is a military form used by and within the U.S. Army. As of today, no separate instructions for the form are provided by the DoD.

Form Details:

  • A 1-page document available for download in PDF;
  • The latest version available from the Executive Services Directorate;
  • Editable, printable, and free to use;

Download an up-to-date fillable DD Form 1721-1 down below in PDF format or browse hundreds of other DoD Forms compiled in our online library.

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Download DD Form 1721-1 "Space Test Program Flight Request Executive Summary"

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UNCLASSIFIED
DATE (YYYYMMDD)
SPACE TEST PROGRAM FLIGHT REQUEST EXECUTIVE SUMMARY
1. EXPERIMENT TITLE
2. SHORT TITLE/ACRONYM
3. EXPERIMENT NUMBER
4. OBJECTIVE
5. DESCRIPTION (Include web site if applicable)
6. RELEVANCE TO SPECIFIC DOD REQUIREMENTS (Include list of key relevant source documents)
7. REQUIREMENTS SUMMARY
d. FLIGHT DURATION
a. EXPERIMENT
b. REQUESTED STP SERVICES
PIGGYBACK FLIGHT
c. REPETITIVE OR
REQUIRED
OTHER (Sounding Rocket, Balloon,
INCREMENTAL
INSTRUMENT
LAUNCH SERVICES/INTEGRATION
(Months)
Micro-G Flight, etc.) (Specify):
COMPLETE
SPACECRAFT ACQUISITION
YES
NO
SPACECRAFT
OPERATIONS/DATA DISTRIBUTION
(If Yes, number):
e. FLIGHT MODE (1=Preferred, 2= Acceptable, UA=Unacceptable)
f. POWER (W)
STAND-BY:
NOMINAL:
MAXIMUM:
FREEFLYER
SHUTTLE
ISS
OTHER
h. MASS (kg)
i. VOLUME (cc)
j. HARDWARE FLIGHT READY DATE (MMM-YYYY)
g. DIMENSIONS (cm)
X
X
l. ORBIT REQUIREMENTS (km)
m. INCLINATION (degrees)
k. STABILIZATION TYPE
APOGEE
+
-
+
-
PERIGEE
+
-
n. OTHER REQUIREMENTS
8. PROGRAM SUMMARY
a. EXPERIMENT FUNDING ($Millions Needed / $Millions Secured)
SOURCE
PRIOR FY FUNDS
CURRENT FY FUNDS
FUTURE FY FUNDS
TOTAL COST
0.00
0.00
/
/
/
/
0.00
0.00
/
/
/
/
0.00
0.00
/
/
/
/
0.00
0.00
/
/
/
/
0.00
0.00
/
/
/
/
b. DESIGN/FABRICATION STATUS
c. CONTRACTOR
9. SERVICE/AGENCY APPROVAL
a. APPROVING OFFICIAL (Last Name, First, Middle Initial)
b. OFFICE SYMBOL
c. POSITION
d. MAILING ADDRESS (Street, Apartment/Suite No., City, State, ZIP Code)
e. TELEPHONE NUMBER(S) (Include Area Code)
COMMERCIAL
DSN
f. SIGNATURE
g. EMAIL
h. PRINCIPAL INVESTIGATOR (Last Name, First, Middle Initial)
i. OFFICE SYMBOL
j. POSITION
k. MAILING ADDRESS (Street, Apartment/Suite No., City, State, ZIP Code)
l. TELEPHONE NUMBER(S) (Include Area Code)
COMMERCIAL
DSN
m. SIGNATURE
n. EMAIL
DD FORM 1721-1, SEP 2006
PREVIOUS EDITION IS OBSOLETE.
Adobe Professional 7.0
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UNCLASSIFIED
DATE (YYYYMMDD)
SPACE TEST PROGRAM FLIGHT REQUEST EXECUTIVE SUMMARY
1. EXPERIMENT TITLE
2. SHORT TITLE/ACRONYM
3. EXPERIMENT NUMBER
4. OBJECTIVE
5. DESCRIPTION (Include web site if applicable)
6. RELEVANCE TO SPECIFIC DOD REQUIREMENTS (Include list of key relevant source documents)
7. REQUIREMENTS SUMMARY
d. FLIGHT DURATION
a. EXPERIMENT
b. REQUESTED STP SERVICES
PIGGYBACK FLIGHT
c. REPETITIVE OR
REQUIRED
OTHER (Sounding Rocket, Balloon,
INCREMENTAL
INSTRUMENT
LAUNCH SERVICES/INTEGRATION
(Months)
Micro-G Flight, etc.) (Specify):
COMPLETE
SPACECRAFT ACQUISITION
YES
NO
SPACECRAFT
OPERATIONS/DATA DISTRIBUTION
(If Yes, number):
e. FLIGHT MODE (1=Preferred, 2= Acceptable, UA=Unacceptable)
f. POWER (W)
STAND-BY:
NOMINAL:
MAXIMUM:
FREEFLYER
SHUTTLE
ISS
OTHER
h. MASS (kg)
i. VOLUME (cc)
j. HARDWARE FLIGHT READY DATE (MMM-YYYY)
g. DIMENSIONS (cm)
X
X
l. ORBIT REQUIREMENTS (km)
m. INCLINATION (degrees)
k. STABILIZATION TYPE
APOGEE
+
-
+
-
PERIGEE
+
-
n. OTHER REQUIREMENTS
8. PROGRAM SUMMARY
a. EXPERIMENT FUNDING ($Millions Needed / $Millions Secured)
SOURCE
PRIOR FY FUNDS
CURRENT FY FUNDS
FUTURE FY FUNDS
TOTAL COST
0.00
0.00
/
/
/
/
0.00
0.00
/
/
/
/
0.00
0.00
/
/
/
/
0.00
0.00
/
/
/
/
0.00
0.00
/
/
/
/
b. DESIGN/FABRICATION STATUS
c. CONTRACTOR
9. SERVICE/AGENCY APPROVAL
a. APPROVING OFFICIAL (Last Name, First, Middle Initial)
b. OFFICE SYMBOL
c. POSITION
d. MAILING ADDRESS (Street, Apartment/Suite No., City, State, ZIP Code)
e. TELEPHONE NUMBER(S) (Include Area Code)
COMMERCIAL
DSN
f. SIGNATURE
g. EMAIL
h. PRINCIPAL INVESTIGATOR (Last Name, First, Middle Initial)
i. OFFICE SYMBOL
j. POSITION
k. MAILING ADDRESS (Street, Apartment/Suite No., City, State, ZIP Code)
l. TELEPHONE NUMBER(S) (Include Area Code)
COMMERCIAL
DSN
m. SIGNATURE
n. EMAIL
DD FORM 1721-1, SEP 2006
PREVIOUS EDITION IS OBSOLETE.
Adobe Professional 7.0
Reset