UNIVERSITY OF THE INCARNATE WORD REQUEST FOR APPROVAL OF ACTIVITY The purpose of completing this form is to: 1) help begin the planning process, 2) schedule the event with the appropriate offices, 3) insure that space is reserved and4) obtain appropriate approvals. If the proposed event includes alcohol, this form must be sumbitted not later than two weeks prior to the event. If not alcohol will be served, this form must be submitted no later than one week prior ot the event. Name of Organization: ______________________________Date Received: ______________ Contact Person: ___________________________________ Phone: ____________________ Description of Event*:_________________________________________________________ *If event involves activities which may increase potential for risk, as determined by the Director of Student Center and Leadership Activities, liability waivers for all participants must be on fil in the Student Life Office prior to the event. Where event is to be held:____________________ Equipment Needed: _________________ Reservation confirmed with : Special Events _____ Residence Life _____ Media Services _____ Other _____ Will transportation be provided? YES NO (If yes, liability waiver forms are needed for each member). Will event be out-of-town or overnight? YES NO (If yes, a completed Excursion Form will be needed.) Will food/beverage be served? YES NO If yes, list items being served: _________________________________________ Source of food/beverage:_________________ Prices to be charged for food/beverage:______________ Are you requesting permission to have beer/wine at the event?:* YES NO *(If alcohol is to be served, 2 TABC Certified servers, 2 designated drivers, and an advisor must be in attendance for the entire event. An application for a campus permit as well as a TABC permit is required two weeks in advance.) Who will provide the beer/wine? ______________________________________ List faculty/staff advisor who will be in attendance at the event:__________________________________________________________ Signature of two designated drivers:____________________________________ Estimated Cost of Event: __________ Source of Funding __________ Admission Charge (if any) __________ We, the undersigned, certify that we are officers of the above named registered student organization and that the event specified will be held in accordance with all federal, state, or local laws or regulations regarding such evets. Further, we assume collective and individual responsibility for the orderly conduct of the event in accordance with all UIW policies. _______________________ ______________________ _______________________ Officer Signature Date Officer Signature Date Advisor Signature (goldenrod copy)     _______________________ _______________________ ________________________ Position Phone Position Phone Date Phone APPROVALS _______________________________________ __________________________________ Director, Student Center & Leadership Activities Date Dean of Student Life (for alcohol) (Original copy)   ___________________________________ __________________________________ Director of Special Events Date Director of Campus Security (for alcohol) Date (pink copy)