Requests
to
hold, provide, serve, or use alcoholic beverages at Lehigh Carbon Community College
('LCCC') must abide
by
the
adopted LCCC Alcohol Policy
as
well as be approved
by
the
President.
Organization/Group/Party Name:
___________________________
_
Contact
Name:-----------------------------------
Contact Email:
-----------------------------------
Contact Phone Number:
Title
of
Event:-----------------------------------
Description
of
Event:
--------------------------------
Date
of
Event:-----------------------------------
CB Banquet Facilities:
Type
of
Alcohol Served:
D Beer D Wine
D Liquor/Mixed Drinks
D Organization using the approved LCCC alcohol vendor:
________________
_
Estimated Attendance:
_________
_
I,
_________________
, have been provided with a copy
of
the Rules
and
Regulations for Use
of
College Facilities, where I have reviewed LCCC's Alcohol Policy. I agree to abide by
all State laws, rules, regulations
and
policy presented.
Signature
of
Requestor
D Approval Given
D Denied
PERM12A-d (3/25/19)
Date
Signed by:
__________
_
Community
Services
Center
Request for Permission to Allow Alcohol on Campus
***Please complete all the questions OR the form will be returned***
