Request to Serve/Sell Alcohol

Applicant Information

Name of Department/Organization:

First Name:

Last Name:

Campus Address: Building - Floor - Room:

Campus Phone:

Mobile Phone:

Home Phone:

Email:

Event Information

Name of Event:

Type of Event:

Date of Event:

Start Time:

End Time:

Location: Building - Floor - Room:

Detailed Description of Event:

Number of attendees:

Type of Attendees:

FacultyStaffGraduate StudentOther

If other, please explain:

Will there be any students or persons under 21 years of age attending?

YesNo

If answer is "Yes", please explain

Department to Pay for Police Detail if assigned:

Department SpeedType:

Type of Alcohol to be served:

WineBeerOther

If other, please explain:

Caterer/License

The caterer is responsible for securing a license to serve/sell alcohol. Please specify the caterer.

UMass Boston AffiliatedOutside UMass Boston caterer

If using an outside caterer, a copy of the license is required. Can you upload a scanned copy of your license to this request?

YesNo

Upload a copy of your license:

License Information

If an outside caterer is used and you are unable to attach an electronic version of the alcohol license, please fax a copy of the alcohol license to Public Safety (617-287-7785) at least 3 days before catered event is to take place.

Caterer Contact Information

First Name:

Last Name:

Phone:

Email:

Company: