Orange County Community College 
Central Scheduling Office 
115 South Street 
Middletown, New York 10940 
Phone: (845) 341-4720 Fax: (845) 341-4721 
 
 
 
REQUEST FOR PERMISSION TO SERVE ALCOHOLIC BEVERAGES ON CAMPUS 
 
Requestor Name:  Today�s Date:  

Group/Organization to be served:  

Event Name:                                                               

Event Purpose/Description:  

Event Date: 
 Start Time:  End Time:   

Event Location:   Building:  Room:  
Person(s) directly in charge of dispensing alcoholic beverages:  


 
Will non-alcoholic beverages be available for those preferring same?  (Y/N) 
 
Will non-OCCC affiliated persons be among guests?   (Y/N)  
If yes, please provide a general description of this group: 

 


 
I understand that no alcoholic beverage can be sold at the above event and that no person under 21 years of age can be supplied with an alcoholic drink. 
 
     _______________________________________ 

      Date               (Signature of person making request) 
 
: PLEASE SUBMIT TO
THE OFFICE OF THE PRESIDENT 
ORANGE COUNTY COMMUNITY COLLEGE 
115 SOUTH STREET 
MIDDLETOWN, NY 10940 
 
 
 
SUNY Orange Employee Alcohol Service Request Decision 
 


 ____ Approved   Disapproved 
 
 
      Comment:  
 

      _______  ____________________________________ 
           Date 
                  WILLIAM RICHARDS, PRESIDENT 
Do Not Write In Shaded Area Below 

SUNY Orange FACULTY/STAFF  
Alcohol Service Permission Form 
 

 Event Date: 

The President�s decision will be returned on this form.   
Approval is not to be assumed unless this form is returned. 

Requestor Name:  


Event Date: