APPLICATION FOR SERVICE, SALE OR CONSUMPTION OF ALCOHOLIC BEVERAGES

Application must be completed and signed by a responsible individual who will be present for the duration of the event.
Please allow a minimum of 10 working days for processing.

Name of Organization/ Department:
Telephone #:	Fax #:	Email:
Date of event:*	Start time:	End time:
*(Any activity held at the same location for the same purpose within a 30 day period qualifies as a single event.)
Location of Event:
Purpose of Event:
Number of Attendees Expected:

Attendees are: (Check all that apply)
FIU Students Only	FIU Employees Only
FIU Students & Employees Only	General Public

Have you assured that your event, as planned, complies with all the conditions of the FIU Alcohol Rule? Yes No
If No, Please attach detailed justification below:
Have you notified the FIU Public Safety Department? Yes No
Date of Notification:
Have you completed and submitted the risk management Event Loss Control Planning Checklist? Yes No N/A Click here to complete the Event Loss Control Planning Checklist

Please read and sign below:

I, the undersigned, acknowledge that I have read the FIU Alcohol Rule and that the information provided in this application is accurate. I affirm that I am the authorized representative for the applicant organization/department hosting this event and that I agree to accept responsibility to assure adherence to conditions of the FIU Alcohol Rule.

Name:	Title:
Panther ID:	Date:

NOTE. After clicking "Submit application" button you will be taken to summary page, where you will have chance to review your application and, if necessary, go back to the form to correct it.