Request to Serve/Sell Alcohol

Name of Department/Organization:*

Applicant:*

Campus Address of Applicant:*

Email:*

Campus Phone:

Mobile Phone:

Home Phone:*

Name of Event:*

Date of Event:*

Type of Event:*

Location of Event:*

Time:*

Number of Attendees:*

Type of Attendees (i.e. faculty, staff, graduate students, etc):*

Will there be any students or persons under 21 years of age attending?* This is a required field.

If answer is "Yes", please explain.

Type of Alcohol to be served:* This is a required field.

If other, please explain.

Person responsible for securing license (Caterer) to serve/sell alcohol (if applicable). Please specify who holds this license:*
If outside caterer is used, please attach an electronic copy of the license using the Browse button below. If you do not have an electronic copy of the license, please fax copy of alcohol license to Division of Student Affairs at 617-287-5811 at least 3 days before catering event is to take place.

Name of Person requesting the use of alcohol:*

Name of responsible Dean/Vice Chancellor:*

Approval Date:*

Please answer the question below. This is to ensure that this form is submitted by a person rather than a robot.*
What color is green grass?