Temporary Liquor Permit Application Form

Temporary Liquor Permit Application Form
Please complete the application for a temporary liquor permit.
Applicant Full Name*
First NameLast Name
Applicant Address*
Street Address
Street Address Line 2
CityState / ProvincePostal / Zip Code
Applicant Phone Number*
Please enter a valid phone number.
Applicant Email*
example@example.com
Event Name*
Event Location*
Event Date*
MonthDayYear
Date
Event Start Time*
Hour Minutes
AM/PM Option
Event End Time*
Hour Minutes
AM/PM Option
Estimated Attendance
Description of Liquor to be Served
Should be Empty: