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Alcohol Permit Form
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Name of Sponsoring Group
Name of Chairperson of Organization/Event
Chairperson's Title
Chairperson's Address
Chairperson's Phone
Chairperson's Fax
Chairperson's Email
Chairperson is the Contact Person?
Name of Event Contact
Contact's Address
Contact's Phone
Contact's Fax
Contact's Email
Event Name
Event Date
Time Range of Alcohol Service
Location Type
- Select -
Indoor
Outdoor
Both Indoor and Outdoor
Room/Location of Event
Type of Function
Purpose of Function
Who will attend?
Number Attending
Number under 21
If any under 21, who are they?
Total Number of Bottles of Wine
Total Number of Bottles of Champagne
Total Number of Bottles of Beer
Total Number of Kegs
Total Number of Pony Kegs
Who is providing the alcohol?
Who is serving the alcohol?
Types of Non-Alcoholic Beverages Provided
Who is the caterer (if known)
Any other questions or comments?
