ALCOHOL BEVERAGE PERMIT

You must schedule an appointment with the Dean of Students to be issued an Alcohol Beverage Permit.

OFFICE OF THE DEAN OF STUDENTS
THE COOPER UNION FOR THE ADVANCEMENT OF SCIENCE AND ART

SPONSORING ORGANIZATION __________________________________

DATE OF APPLICATION _________________________________________

DATE OF EVENT _______________________________________________

TIME OF EVENT _______________________________________________

LOCATION ____________________________________________________

HAVE YOU ORDERED SECURITY GUARDS?

______________________________________________________________

______________________________________________________________

PERSONS RESPONSIBLE (2):

NAME _________________________________________________________

ADDRESS ______________________________________________________

TELEPHONE ___________________     EMAIL ________________________


NAME _________________________________________________________

ADDRESS ______________________________________________________

TELEPHONE ___________________     EMAIL ________________________

We agree to comply with the laws of the State of New York and the regulations
of The Cooper Union with regard to use of Alcoholic Beverages on the campus of
Cooper Union for this event. In particular, we assume the responsibility for
complying with the state laws forbidding the use, possession and sale of alcoholic
beverages by minors less than 21 years of age, and we understand that no
alcoholic beverages except beer and wine shall be served or available at this event.


Signed __________________________          Date ______________________

Signed __________________________          Date ______________________

Approved ________________________         Date ______________________
                                    Dean of Students