Request to Use Alcoholic Beverages on University Property - Auxiliary Services

Request must be submitted four weeks prior to the date of intended use.

All fields required.

Hosting Information

Department/Organization:

Address:

Phone Number:

Contact Information

The person primarily responsible for the event

Name:

Address:

Phone Number:

Event Information

Location:

Date:

Start Time: (include a.m. or p.m.)

End Time: (include a.m. or p.m.)

Estimated Attendance: (max)

Description/Purpose:

Type of Alcohol Served:

Primary Attendee Type: Faculty/Staff
Student
Other

Age Range: (for majority of the attendees)

Does your group/organization require security at the event? Yes
No

Has your group/organization had a security/police concern, incident and/or an action that has occurred at an event you have hosted in the past? Yes
No

If yes, please explain:

Follow-up Meeting Date: (should be one week prior to event)

RESPONSIBLE PERSON AT THE ACTUAL EVENT: All persons attending the activity must comply with applicable federal, state and University regulations. I accept personal responsibility for ensuring that University policy and state laws governing the use of alcoholic beverages are complied with, and accept financial responsibility for the activity.

Legal Signature: