Events with Alcohol Registration Forms

Stephanie Ives, Ed.D.
Director
Julie Lyzinski, M. Ed
Associate Director
3611 Locust Walk
3rd Floor
Philadelphia, PA 19104-6222
215.573.3525
Fax: 215.573.7944

ivess@pobox.upenn.edu

On-Campus Alcohol Event Registration Form
for UNDERGRADUATE STUDENT ORGANIZATIONS ONLY

NOTE: You must print the form using the button on the bottom of this page. You must then have it signed and HAND IT IN to the Office of Alcohol Policy Initiatives at 3611 Locust Walk, 3rd Floor

Organization: Organization Type:	Date of Event: SUBMISSION DEADLINE: 1 week prior to event
Co-Sponsor:	Time: until
Contact person: Phone: Email:	Street Address/Location:
Responsible Host: Phone: Email:

Describe Event:
Invite Only
"Open" (Large Party)

Anticipated # attending:
Anticipated # legal age partifipants:
Theme:

Checklist:
In order to host an event, we understand that we must be in compliance with PA state law, university policies, in the case of Greek organizations, national fraternity insurance guidelines, and the University’s Alcohol and Drug policy.

	We will not serve hard alcohol.
	We will limit available alcohol to 4 (12oz.) beers or 4 (5 oz.) glasses of wine, per guest/member of legal age.
	We will have sober organization members available in the ratio of one member for every 30 guests present.
	We will supply an ample amount of food.
	We will supply an ample amount of non-alcoholic beverages.
	We will be using the doorperson listed below.
	We understand that only people of age can serve and dispense alcohol.
	We will be using the following form(s) of checking ID: Driver’s License/Passport (required) Penn I.D. or other identification (please indicate) (Two forms of ID required)
	We will not charge a cover/entertainment fee/sell cups, ask for donations, etc.
	We will not serve alcohol after 1:00A.M.
	We will use wristbands and/or other forms of verification for legal-age attendees

Every box MUST be read and checked

Competency Plan will be attached to this registration form.
Competency Plan has been handed in already.

Bartender

Name:
Phone:
Is this bartender on the University Approved list?	Yes No

If the event is over 50 attendees:

Doorman/Security Company:
Phone:

Greek Officer Information
(Fill out ONLY if you selected GREEK from the Organization Type above)

President
Name
Phone
Email

Social Chair / Risk Mgt
Name
Phone
Email

Co-host Preseident
Name
Phone
Email

Co-Host Social Chair / Risk Mgt
Name
Phone
Email

Remember: You need to print this form, have it signed, and submit it to the Office of Alcohol Policy Initiatives (3611 Locust Walk, 3rd Floor) to complete your party registration