SA-1475.1C December 16, 1997

REQUEST FOR PERMISSION TO SERVE ALCOHOL

Campus:

Organization/Department.:

Date of Function:        Hours: (from)         (to) 

Location of Function:

Advisor/College Official(s) to be Present:

Number of Police Officers Required:

Type(s) of Alcohol to be Served:

College Administrator/Student Organization Advisor Responsible for Enforcing College Policy and Procedures for Serving Alcohol during the Function:

__________________________________    __________________________________

Signature            Date

___________________________________

Title

Signature Approvals:

______________________________________    ___________________________

Vice Chancellor for Student Affairs        Date

______________________________________    ____________________________

Chancellor              Date

Form 1475/001 (6/12)

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