Alcohol Use Application Form

All fields are required.

Please make sure to fill out this form COMPLETELY before clicking the "Submit" button.

Contact Information
The undersigned accepts responsibility for adherence to the alcohol policy and University standards related to the service of alcohol on campus for this event.
Contact Person:
Phone Number:
Fax Number:
E-mail:
Re-Enter your E-mail Address to verify:
Department:
Building:
Room:
Application Date:
Event Information
Sponsoring Department/Organization:
Event Date(s):
Event Title/Description:
Event Location/Venue (Building Name/Room):
Event Type:
Purpose of Event:
Who will attend:
Anticipated No. Attendees:
% of Attendees under 21:
Event Day Contact Person:
Phone Number:
*The Event Day Contact person must be present and remain sober during the time alcohol will be served.
Please describe the alcohol monitoring process in place for this event:
Event Start Time:
Alcohol Service Start Time/End Time:	*Alcohol service must end 45 minutes prior to event end time.
Event End Time:
University Alcohol Standards
The responsible person acknowledges they have read and agrees to adhere to the University Alcohol Policy. Types of Alcoholic Beverages & Quantity: Beer Wine # of Servings: Standard Serving Size: Beer: 12 oz. Wine: 4-5 oz. Recommended Consumption: 1 Drink Per Person Per Hour *Equal amount of non-alcoholic beverages and food must be available
Alcohol Verification
Alcohol must be served by a licensed third party. The licensed third party must hold a state issued license permitting them to serve alcohol. The licensed third party accepts responsibility for managing the alcohol service, controlling alcohol consumption and ensuring compliance with all state laws and University policies.
Who is Providing the Alcohol:
Who will serve the Alcohol: (if different from provider):
Phone/Fax:
Address/State/Zip code:
E-mail:

All fields are required.

Please make sure to fill out this form COMPLETELY before clicking the "Submit" button.