Alcohol Beverage Service Permit
Alcoholic Beverage Service Request Form
Application Details
Organization
*
Name (Person In Charge)
*
Email (Person In Charge)
*
Phone (Person In Charge)
*
UIC Sponsoring Unit
*
Name of Unit Head Or Faculty/Staff Sponsor
*
Email of Unit Head Or Faculty/Staff Sponsor
*
Event Name
*
Event Purpose
Development
Conference/Convention
Cultural
Educational
Event Type
UIC Student
Faculty
Staff
Non-UIC
Type of Beverage or Type of Bar Service
Beer
Wine
Alcoholic Punch
Wine Punch
Full Bar Service
Cash Bar
Other
Event Date
*
Event Day
*
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday
Event Begin Time
*
Event End Time
*
Space Reserved
Venue
*
Other
CU1 Arena
Forum
Room
*
Estimated Attendance
*
Will everyone in attendance be at least 21 years old?
*
Yes
No
What measures will be taken to maintain acceptable behavior and compliance with laws and university rules?
*
Will there be non-University of Illinois at Chicago attendance?
*
Yes
No
If tickets are sold and/or an admission fee is required/requested, how will the funds be used?
What will be done if there is income in excess of the event expenses?
Will there be a program or entertainment?
*
Yes
No
Will this event be advertised?
*
Yes
No
What will be the source of funds to purchase alcoholic beverages?
*
Will the event be catered by UIC Catering?
*
Yes
No
What type of food service has been requested from Catering?
Meal
Refreshments/Snacks
Other
Have alcoholic beverages been ordered from Catering?
Yes
No