APPLICATION FOR USE OF ALCOHOLIC BEVERAGES ON CAMPUS
COPY OF CONFIRMATION LETTER WILL BE SENT TO THE DEANS/CHAIRS AND CHIEF OF POLICE
*R
ETURN TO RISK MANAGEMENT, M/S LS 140
EVENT SPONSOR:
DESCRIPTION OF EVENT:
EVENT LOCATION:
DATE:
START TIME: AM PM END TIME: AM PM
FOOD TO BE SERVED:
CHARGE FOR MEALS: YES NO NUMBER EXPECTED TO ATTEND THIS EVENT?
REASON FOR ALCOHOL TO BE SERVED:
WILL UNDERAGE INDIVIDUALS BE IN ATTENDANCE? YES NO
SPONSORS MUST OBTAIN PERMISSION TO SERVE ALCOHOLIC BEVERAGES AND IT WILL BE GRANTED ONLY
IF THE FOLLOWING CONDITIONS ARE MET:
1. NO INDIVIDUAL UNDER 21 YEARS OF AGE WILL BE SERVED ALCOHOLIC BEVERAGES.
2.
NO INDIVIDUAL OR PERSONS WHO APPEAR INTOXICATED WILL BE SERVED ALCOHOL BEVERAGES.
3.
ALCOHOLIC BEVERAGES WILL BE LIMITED TO BEER AND WINE.
4.
DIRECT ACCESS TO EVENTS WHERE ALCOHOL IS BEING SERVED MUST BE RESTRICTED TO INVITED GUESTS ONLY.
THIS IS THE RESPONSIBILITY OF THE SPONSOR.
5.
NON-ALCOHOLIC BEVERAGES AND HIGH-PROTEIN FOODS MUST BE READILY AVAILABLE TO ALL PARTICIPANTS, AND
FEATURED AS PROMINENTLY AS THE ALCOHOLIC BEVERAGES.
6.
FOOD SERVICES MUST BE CONTACTED PRIOR TO THE SCHEDULING OF THE EVENT TO COORDINATE THE DETAILS OF
SERVING/SUPPLYING THE FOOD AND/OR ALCOHOLIC BEVERAGES.
7.
AN EVENT SPONSORED BY A STUDENT ORGANIZATION(S) MUST HAVE THE ADVISOR’S SIGNATURE ON THE
APPLICATION.
8.
ALCOHOL WILL NOT BE SOLD BY THE SPONSORING DEPARTMENT/ORGANIZATION.
THIS FORM MUST BE SUBMITTED TO THE OFFICE OF ENVIRONMENTAL HEALTH AND SAFETY / RISK
MANAGEMENT (EHS/RM) NO LATER THAN (2) TWO WEEKS PRIOR TO THE EVENT IN ORDER FOR REVIEW
AND APPROVAL AND TO OBTAIN APPROPRIATE REQUIRED SIGNATURES. IF YOU DO NOT RECEIVE A
CONFIRMATION LETTER FROM EHS/RM THE EVENT CANNOT INCLUDE ALCOHOL.
B
Y SIGNING THIS APPLICATION, I SIGNIFY THAT I HAVE READ AND AGREE TO ABIDE BY THE
POLICIES AND PROCEDURES SET FORTH BY THE
CALIFORNIA STATE UNIVERSITY, FRESNO “POLICY ON
CAMPUS USE OF ALCOHOLIC BEVERAGES”. A COPY OF THE POLICY IS ATTACHED.
__________________________ __________________________ ______________
PRINT
APPLICANT’S NAME SIGNATURE DATE
__________________________ __________________________ ______________
PRINT
ADVISOR’S NAME SIGNATURE DATE
A
PPROVED ___ YES ___ NO __________________________ ______________
FOOD SERVICES DATE
APPROVED ___ YES ___ NO __________________________ ______________
D
AVID HUERTA DATE
POLICE CHIEF
APPROVED ___ YES ___ NO __________________________ ______________
D
R. PAUL OLIARO DATE
VICE PRESIDENT FOR STUDENT AFFAIRS
APPROVED ___ YES ___ NO __________________________ ______________
STEVE MARTINEZ DATE
DIRECTOR OF ENVIRONMENTAL HEALTH & SAFETY
