Form: temporary-bartender-operator-license-application

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Temporary Bartender (Operator) License Application

Fee: $10.00

License is granted for up to 14 days.

Application to serve / sell malt beverages and/or wine at picnics or similar gatherings during an event lasting less than 4 days (held by bona fide clubs, fair associations, agricultural societies, churches, lodges, or other societies in existence at least six (6) months prior to event)

Start Date of License

End Date of License

Organization under which you are applying for license:

Applicant Name

First

Middle

Last

Applicant Date of Birth

Applicant Gender

Male

Female

Prefer Not to Answer

Applicant Driver's License Number

Applicant Phone Number

Applicant Address

Street Address

Applicant Address

City

State/Province

Zip/Postal

Have you ever been convicted of a felony?

Yes

Have you ever been convicted of violating any law of the State of Wisconsin or of the United States?

Yes

If Yes, provide conviction type, jurisdiction, and year of conviction.

Have you been convicted of violating any license law or ordinance relating to the sale of fermented beverages or intoxicating liquors?

Yes

If Yes, please provide details:

Upload Picture of Driver's License

Maximum file size: 52.43MB

I hereby apply for a license to serve fermented malt beverages and wine, subject to the limitations imposed by WI Stats §125 and all acts amendatory thereof and supplementary thereto, and hereby agree to comply with all laws, resolutions, ordinances, and regulations, federal, state, or local affecting the sale of such beverages if a license be granted to me.

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Date

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Temporary Bartender (Operator) License Application

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