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10. Has the applicant been convicted of a felony in the past five years or had a liquor license revoked?
IJ YES NO (attach explanation if yes)
11. This organization has been issued a special event license for 0 days this year, including this event
(not to exceed 10 days per year).
12. Is the organization using the services of a promoter or other person to manage the event? 0 YES SIN°
If yes, attach a copy of the agreement.
13. List all people and organizations who will receive the proceeds. Account for 100% of the proceeds.
THE ORGANIZATION APPLYING MUST RECEIVE 25% OF THE GROSS REVENUES OF THE SPECIAL
EVENT LIQUOR SALES.
Name Ve...5escv NvizEs Zwzype-t-L- shotv CIADvLos k eyo 70'
Percentage
Address
Name
Percentage
Address
(Attach additional sheet if necessary)
14. Knowledge of Arizona State Liquor Laws Title 4 is important to prevent liquor law violations. If you have
any questions regarding the law or this application, please contact the Arizona State Department of Liquor
Licenses and Control for assistance.
NOTE: ALL ALCOHOLIC BEVERAGE SALES MUST BE FOR CONSUMPTION AT THE EVENT SITE ONLY.
"NO ALCOHOLIC BEVERAGES SHALL LEAVE SPECIAL EVENT PREMISES."
15. What security and control measures will you take to prevent violations of state liquor laws at this event?
(List type and number of security/police personnel and t ype of fencing or control barriers if applicable)
# Police Fencing
# Security personnel n Barriers
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16. Is there an existing liquor license at the location where the special event is being held? DYES MNO
If yes, does the existing business agree to suspend their liquor license during the time
period, and in the area in which the special event license will be in use? DYES DNO
(ATTACH COPY OF AGREEMENT)
Name of Business Phone Number
17. Your licensed premises is that area in which you are authorized to sell, dispense, or serve spirituous liquors
under the provisions of your license. The following page is to be used to prepare a diagram of your special
event licensed premises. Please show dimensions, serving areas, fencing, barricades or other control
measures and security positions.

SPECIAL EVENT LICENSED PREMISES DIAGRAM
(This diagram must be completed with this application)
Special Event Diagram: (Show dimensions, serving areas, and label type of enclosure and security positions)
NOTE: Show nearest cross streets, highway, or road if location doesn't have an address.
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THIS SECTION TO BE COMPLETED ONLY BY AN OFFICER, DIRECTOR OR CHAIRPERSON OF THE
ORGANIZATION NAMED IN QUESTION #1
18 A-D C-VN declare that I am a Officer Director/Chair arson appointing the
(Print full name)
applicant listed in Question 6, to apply on behalf of the foregoing organization for a Special Event Liquor License.
Mas\PG_al a.f3 -SILAIN-
(SigT (Title/Pos' ion) (Date) (Phone #)
County of Wri
The foregoing instrument was acknowledged before md this
JOANNE M. VANDERLOO
Notary Public - Arizona
Maricopa County Day I-•••I Mo9th 7-) Y
Wr - YiThYsYdriukTiggi arY.. 180 ?)7314.4
(Date) (Signature of NOTARY PUBLIC)
THIS SECTION TO BE COMPLETED ONLY BY THE APPLICANT NAMED IN QUESTION #6
19. I, \DM 5Thcbc--e '01 C)A. declare that I am the APPLICANT filing this application as
(Print full name)
listed in Question 6. I have read the application and the contents and all statements are true, correct and complete.
State of "1---7N-L4 County of
rn-L
JOANNE M. VANDERLOO Day Month / ear
miggt9ff 8*Wes4C6itiPi
Maricopa County (Signature of NOTARY PUBLIC
1911
approval. City or County MUST recommend event and complete item #20.
The local governing body may require additional applications to be completed and submitted 60 days
in advance of the event. Additional licensing fees may also be required before approval may be granted.
LOCAL GOVERNING BODY APPROVAL SECTION
20. I, hereby recommend this special event application
(Government Official) (Title)
on behalf of
(City, Town or County) (Signature of OFFICIAL) (Date)
FOR DLLC DEPARTMENT USE ONLY
Department Comment Section:
(Employee) (Date)
0—A1PROVED 0 DISAPPROVED BY:
(Title) (Date)

15 SPECIAL EVENT LICENSE (Temporary)
SERIES::
Non-transferable
On-sale retail privileges
PURPOSE:
Allows a charitable, civic, fraternal, political or religious organization to sell and serve spirituous
liquor for consumption only on the premises where the spirituous liquor is sold, and only for the
period authorized on the license. This is a temporary license.
ADDITIONAL RIGHTS AND RESPONSIBILITIES:
The applicant for a special event license must request a special eVent application from the
Department and file the application with the governing body of the city or town, or Board of
Supervisors of an unincorporated area of a county (where the special event is to take place) for
approval or disapproval. Some local governing bodies may require approximately 60 days prior
notice.
If the application is approved by the local authority, and the event meets the requirements for
granting the license, the Director will issue a special event license to the qualifying organization.
Qualifying organizations will be granted a special event license for no More than ten (10) days in a
calendar year. Events must be held on consecutive days and at the same location or additional
licenses will be required. The license is automatically terminated upon closing of the last day of
the event or the expiration of the license, whichever occurs first.
The qualified organization must receive at least twenty-five percent (25 %) of the gross revenues
of the special event liquor sales.
A person selling spirituous liquor under a special event license must purchase the spirituous
liquor from the holder of a license authorized to sell off-sale; except that, in the case of a
non-profit organization which has obtained a special event license for the purpose of charitable
fund raising activities, a person may receive the spirituous liquor from h wholesaler as a donation.
AVERAGE APPROVAL TIME: One (1) to seven (7) days.
PERIOD OF ISSUANCE:
Issued for no more than a cumulative total of ten (10) days in a calendar year. A special event
may be held for more than one (1) day, but it must be held on consecutive days and at the same
location or additional licenses will be required.
FEES: $25.00 per day.
ARIZONA STATUTES AND REGULATIONS:
ARS 4-203.02, 4-244, 4-261; Rule R19-1-228, R19-1-235, R19-1-309.
Disabled individuals requiring special accommodations please call (602) 542-9027