<p> ALCOHOLIC BEVERAGE ACTIVITY</p><p>Name of Organization______Date______</p><p>Person Making Request______ID#______</p><p>Address______Phone______</p><p>TYPE OF ACTIVITY</p><p>______Departmental ______Closed Social ______Student Organization ______Free ______Charge ______Residence Hall ______Open (ALLCAMPUS) Social ______Other ______Free ______Charge</p><p>Type of Beverage______</p><p>DESCRIPTION OF EVENT______</p><p>DATE (S) OF EVENT______TIME ______AM/PM______AM/PM</p><p>LOCATION______ROOM ASSIGNED______</p><p>ANTICIPATED ATTENDANCE______</p><p>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.</p><p>Signature of Organization President (Yellow Copy) Date</p><p>Signature of Sponsor Date</p><p>University Police Director/Designee (Blue Copy) Date</p><p>Facility Director/Coordinator (Pink Copy) Date</p><p>Food Service/Alcoholic Beverage Contractor (Green Copy) Date</p><p>Dean of Students/Designee (White Copy) Date</p>