Alcoholic Beverage Activity

ALCOHOLIC BEVERAGE ACTIVITY

Name of Organization______Date______

Person Making Request______ID#______

Address______Phone______

TYPE OF ACTIVITY

______Departmental ______Closed Social ______Student Organization ______Free ______Charge ______Residence Hall ______Open (ALLCAMPUS) Social ______Other ______Free ______Charge

Type of Beverage______

DESCRIPTION OF EVENT______

DATE (S) OF EVENT______TIME ______AM/PM______AM/PM

LOCATION______ROOM ASSIGNED______

ANTICIPATED ATTENDANCE______

The undersigned, in connection with the application to reserve a facility for the event described, certifies that (1) such function will not be restricted on the basis of race, religion, sex or national origin, (2) such function will normally be restricted to university – related groups, (3) appropriate person (s) will be present at the function to insure the proper use of the facility, (4) such function and use of the facility will not violate any law of the state, rule or regulation of the university. Furthermore the undersigned agrees to (a) reimburse the university for any loss, damage, or expense, and (b) is aware the university will not assume any liability. Beverage servers must be present at all events in which alcohol is served and must be seller/server trained through a certified TABC School to dispense alcohol. Police officers must be present unless an exception is granted by the University Police Director//Designee.

Signature of Organization President (Yellow Copy) Date

Signature of Sponsor Date

University Police Director/Designee (Blue Copy) Date

Facility Director/Coordinator (Pink Copy) Date

Food Service/Alcoholic Beverage Contractor (Green Copy) Date

Dean of Students/Designee (White Copy) Date