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Application for Temporary Liquor License <br />Please check all of the following that apply: <br />Type of License: <br />MOn Sale Intoxicating Liquor (One to Four Days) <br />• Spirits/Liquor <br />• Wine (Up to 14% alcohol) <br />❑ Consumption & Display (Setup) (One Day) <br />❑ 3.2% Beer On Sale (One to Four Days) <br />❑ Off Sale - Wine Auction (Check with State <br />Gambling Division) <br />Fee: $25.00 <br />Date Paid: <br />Receipt #.- <br />Type of Organization: <br />❑ Club <br />Charitable <br />❑ Religious <br />❑ Other Nonprofit <br />❑ Political Committee <br />❑ State University <br />Date(s) liquor will be served and/or sold. �,:"vOPA-7 I ®GTf V 664L —4 <br />Phi 5 LJe-Sea.4&`T <br />Location liquor will be served and/or sold: �'Q W • tn/r442 4-i A ! LVJ9 . <br />Please describe the social event sponsored by the licensee: <br />1. Name of Organization: <br />-M 4 <br />t.,AM P <br />�� T <br />OJ - <br />(,0,V6 J <br />2. Name of Applicant:__ <br />P-0 VAJ <br />L/M aP <br />3. Contact Information: <br />(Phone) (email) <br />4. Type of event: l TL-( t T �I� t V i ilJ <br />5. Name of the event: �� 7-E- 04C LoAjb LA -(LE <br />6. Hours of the event: (P <br />7. Number of guests (approximately): l �J <br />Who will be serving the liquor? I AV61t L4 Q va. PKMJ fvTVAS <br />9. Will this event be open to the general public? ❑ Yes ANO <br />10. Is this event by invitation only? ❑ Yes MNo <br />11. Are tickets sold for admission to the event? ❑ Yes bdNo / 6vT 00a✓A-!r7e^,< JU- f - <br />TA -/-40 L;')- 7'7% 06747e <br />12. If tickets are sold, for what purpose are net profits used? <br />190 *- 749 A -f- E- 14700/ TP 65�K-17- cg -0?2�-S <br />13. If tickets are sold, is liquor included with the price of the ticket? ❑ Yes A. No <br />Page 2 <br />