Alcohol Request Form

Application for permission to use, serve, and distribute alcoholic beverages

Sponsoring Organization or Person:
Application Submission Date:
Contact Person:

Name

Position

Address

Phone Number and ESF/SYR Email Address

Type of Event:

Date:
Times: From until

Location:

Estimated Attendance:

Event is open to whom?:

Food and Beverages to be served:
Alcoholic Beverages: Type ______________ Quantity Available: ________________

Non-Alcoholic Beverages: Type
Quantity Available:

Food:
Quantity Available:

Financial Arrangements: (Please check appropriate box and explain)

a.____Event is free to participants.

b.____Event has an associated admission charge. (The service and/or consumption of alcohol is not permitted at events with an associated admission charge, including donations.)

Explanation of event funding:

If the event is a student club/organization sponsored event, the name and contact information of the faculty/staff advisor or faculty/staff member who endorses the event and who commits to being in attendance for the entirety of the event:

Name
Phone Number and ESF/SYR Email Address

Supervision of Serving of Alcoholic Beverages: (Please check appropriate box and explain.)
____ Event is being catered by Morrisville Auxiliary Corporation (MAC).
____ Event is being catered by an outside caterer.

Name of Caterer
Contact Person

Address of Caterer
Phone Number/Email Address

State Liquor Authority License Number

A copy of the one-day permit to serve beer or wine at the event obtained by the caterer must be provided to the Vice President for Administration (or designee) at least two (2) weeks in advance of the event or the event will be cancelled.

Explanation of process for control of distribution of alcohol only to people of legal drinking age and within the scheduled facility, registration of guests, and advertising:

Signatures/Person(s) Responsible:
For all events, the person responsible must be of legal drinking age or older.
For Undergraduate Student Association and Graduate Student Association sponsored events, three signatures are required:
The person responsible must be 21 years of age or older and must hold a formal position within the organization that allows him/her to plan events with alcohol.
The treasurer or president of the organization must cosign.

iii. A faculty/staff advisor or faculty/staff member who must commit to being in attendance for the entirety of the event must cosign.

All events must be catered by a licensed caterer having the appropriate State of New York permit to serve alcohol as well as adequate liability insurance. In all cases, a one-day permit to serve beer or wine must also be requested from the New York State Liquor Authority at least six (6) weeks in advance of the event. The following signatures are also required:
For events catered by Morrisville Auxiliary Corporation (MAC), the signature of the appropriate MAC manager.
For events catered by an outside caterer, the signature of the appropriate outside catering manager.

I have read the “Policy Governing the Use and Distribution of Alcoholic Beverages on the ESF Campus, on ESF-Owned and/or Associated Properties, and in ESF-Designated Housing Facilities,” and understand the department/organization/entity responsibilities and liabilities in regard to ESF’s policies and in regard to federal, state, and local laws, rules, regulations, and statutes concerning alcohol and alcoholic beverages and in particular, relative to the use and distribution of alcoholic beverages. I affirm that all information reported on this form is complete and accurate.

Person Responsible (See Above):

Name (Printed)
Department/Student Organization
Position