A. Name of University College or Department Hosting Event: Fill in the name of the college or department. This must be a UA department or college, e.g., the College of Fine Arts, the Athletics Department, etc. There must be a University department/unit hosting the event in order for alcohol to be served.

College/Department Applicant: Clearly print the name of the individual applying for the permit. This must be a College or Department Dean or Director. The applicant must have the authority to make such application on behalf of the University, College or Department. Include the applicant's phone and fax numbers. An original signature of the applicant is required

Responsible UA Employee in Attendance at Event: A responsible adult from the hosting department must be in attendance at the entire event. This doesn't necessarily have to be the same person as the applicant. Contact information is required.

Purpose Related to University Mission: According the UA guidelines, "The event must serve a University purpose," if alcohol will be served. Indicate how the event is related to the mission of the University. Some examples might be fundraising, donor relations, advisory board meeting, visiting scholar lecture/reception, community outreach event.

B. Name of Third-Party Sponsor Organization co-Hosting Event (if any):
This is where you will fill in the name of any outside organization/entity co-hosting the event, e.g. Raytheon, Bank of America, etc. (Do not use this space for the name of University applicant.) An authorized representative of the Third-Party co-host must sign the form, binding the Third-Party to each of the provisions of the Permit, including the indemnification provisions of Paragraph 11 and the University's Alcohol Policy. Include the third-party sponsor's address and phone, and explain its affiliation with the University. Do not fax the forms to/from the Third-Party co-host. Have the original form filled out, signed and returned to you for completion.

Indemnification by Third-Party Sponsor organization: This section explains the indemnification responsibilities that Third-Party Sponsors must agree to provide.

A. Check all of the following that apply to the event:
There are five questions under #2. If you check any item(s) "Yes", service will be limited to two drinks per person under the Public Facilities Exemption; unless a Special Event Liquor License is obtained from the Arizona Department of Liquor (requires special permission from the University President). These rules are for compliance with the State Liquor law prohibitions on the sale of alcohol and related Arizona Department of Liquor regulations.

C. Will the college organization apply for a Special Event Liquor License?
Check yes or no. Be advised that obtaining a Special Event Liquor License requires special permission from the University President, and then applying for the license through the City of Tucson and the Arizona Department of Liquor Licenses and Control. It is an involved process and not all organizations will qualify. Most University organizations choose to comply with the rules set forth in the UA application for a permit to serve alcohol rather than applying for a Special Event Liquor License. Alcohol may be served without a license at events on campus where there is no sale.

D. Type of Alcohol to be served? Check all that apply: beer, wine, and/ or hard liquor. UA prohibits the service of spirituous liquor such as whiskey, gin, rum. Special permission is needed in order to serve spirituous liquors in addition to a Special Event Liquor License.

E. Please check what applies

F. Please check what applies

G. Name of approved bartender or alcohol service contractor: Alcoholic beverages must be served by a contractor who has a certificate of insurance on file with the University and agrees to be bound by the provisions of the Permit. The University does not recommend bartenders, but we can tell you who has approved insurance certificates on file with us.

Note: The bartending service must read and complete the information providing a signature. All bartending signatures and initials must be original. DO NOT fax the form to the bartender for signature and have them fax it back. All forms not having original signatures where required will be returned to the applicant for re-processing which may delay the review process.

Bartenders Initial & Date: Bartenders must manage alcohol service, control alcohol consumption and ensure compliance with the Arizona Liquor Laws and Regulations. Bartenders must read the information and sign. An original signature is required for this acknowledgement.

A. Event Name and Date:
The name - XYZ Reception - and the date the event will be held.

B. Event Description & Attendance:
Describe the event such as Reception, Dinner, Awards Ceremony. If several phases of the event take place such as an Awards Dinner with reception please indicate. Provide the number of people you expect to attend.

C. Exact location:
The name of the room, hall and building or area where the event will be held. For example McClelland Atrium, Room 203 of McClelland Hall. If in any area outside on University grounds provide a general location using existing landmarks. Time: The beginning and ending time of the event. Do not include set up or breakdown time. This time is when the event officially begins and ends.

D. Alcohol Service Time:
Provide the times at which alcohol will be served within the start and end time of the entire event as indicated above. If service occurs during the entire event indicate the same time as above.

E. List all persons and entities that will receive the gross proceeds from the event:
Gross proceeds include all monies collected from admission fees, and the sale of food and beverages.

F. Will the majority of attendees be University employees?
Check yes or no. Consideration should be given to the hours an event is being held where alcohol is being served if the majority of attendees will be University employees not during work hours. Generally, the majority of persons at events with alcohol should be non-University attendees.

G. Name of the person or entity donating alcohol for the event, if any:
This may be an individual or group.
PLEASE NOTE: No University funds may be used to purchase alcohol and no donations of liquor may be received from a liquor wholesaler without a Special Event License.

PLEASE NOTE: Alcohol cannot be the main focus of the event. The presence of alcohol requires the accompaniment of food as outlined by the UA catering policy.

A. University approved food/beverage caterer will be:
Under the University Catering Policy, events with food costs of $500 or more must use Student Union Dining Services. Departments at AHSC have the option of using the UMC food service. Events costing less than $500 have the option of using a University approved outside caterer. A list of approved outside caterers can be found at: http://pacs.arizona.edu/contract/Catering_List.pdf. Applicant must provide name of UA approved caterer and initial having read and agreeing to the University Catering Policy.

B. Approximate cost per person for this event

A.Will any attendees be under the age of 21?
Check yes or no. If the answer is yes, you should provide an explanation on how those under aged people will be prevented from loitering in and around the area in which the alcohol is being served. For example, the bartending service will place soft barricades or post signs, and the bartending service will take steps to determine the ages of persons requesting alcohol.

B. Boundaries, fencing, barriers and staff to control liquor consumption:
In order to serve alcohol at events on campus, there must be defined boundaries to the areas where individuals may consume alcohol. Be clear in describing the boundaries, e.g. "limited to McClelland atrium." Also include any steps that will be taken to control attendees from leaving the area with alcohol such as security staff etc. If a two drink maximum is in effect, then you must outline how the two drink maximum will be monitored such as drink tickets etc.

C. Answer as it applies to your location

D. Answer as it applies to your location

E. Will there be security?
Check yes or no. If yes, indicate who is providing security. Remember that staff may serve this function to a limited extent. The hiring of outside security, other than UAPD employees, (police aides or police officers) must meet current UA Purchasing and Contracting guidelines. UAPD will review this closely to determine any conflicts or make recommendations pending prior approval by UA Campus Life.