GREEK INDEPENDENCE DAY CELEBRATION_REDACTED.PDF

Arizona Department of Liquor Licenses and Control DLLC USE ONLY

https://www.azliquor.gov Job #
(602} 542-5141 Date Accepted:
icy
SPECIAL EVENT LICENSE
license #;
MUST be submitted to the Department of Liquor to the event.

Name of Non-Profit Organization, Candidate or Political Party: St Katherine Greek Orthodox Church

if the event will be held on an unlicensed premises, it be approved and signed by the Local Governing
Body Before submitting to the Arizona Department of Liquor.

LOCAL GOVERNING BODY

Date Received:

1, [1 approval [1] pisapprovat

Goverment Official Title

On behalf of

‘City, Town, County Signature

Will the event be at a location with a current liquor license and within the approved and licensed area?

Clyes []No (if no skip to section 3}

Name of Licensed Location Liquor License Number

C4 Suspend license for the duration of the Special Event; Licensee selling all alcchol without retailer involvement.

[1 _ Dispense and serve all spirituous liquors under retailer's license ~ Business operates normally, minimum of 25% of
gross revenue from alcohol sales will be donated to licensee.

EC] Dispense and serve all spirituous liquors under special event - The special event licensee is in charge of selling alcohol
that was purchased or donated by the special event licensee. The retailers existing alcohol inventory must be kept
separate from any alcohol used during the special event.

CC Split premises between special event and licensed location - Both the special event licensee and the licensed
location will conduct sales of alcohol. (These sales must be done in separate areas. !f alcohol is donated or purchased
by the special event licensee, it must be in a separate area from the alcohol that is dispensed by the licensed
location.)

Cl Off Sale only - Wine/Distilled Spirits Pull, Live or Silent Auctions — Retailer will be permitted to conduct all normal
sales and service of alcohol.

10/28/2025 Page J of 4
Incividudis requiting ADA accommodations please call {602)542-2999

1. Applicant: Archuleta Evangelia
 “ iia Middle
2. Applicant’s mailing address:

cry State ip

3. Applicants home/cell phone Non-profit organization phone: 480-899-3330

4. Applicant's email addres:

5. Has the applicant been convicted of a felony, or had a liquor license revoked within the fast five (5) years?
Clyes (if yes, attach letter of explanation) No

SEO VE SL

1. Name of non-profit organization; St Katherine Greek Orthodox Church

2. Non-Profit/IRS Tax Exempt Number: 94-2876533 ___ Arizona Corporation Commission File #: 01524110

3. IF Out Of State, specify State (Attach letter of good standing):

4, Special Event Name: Greek Independence Day celebration

5. Event Location Name: ot Katherine Community Center

6. Event Address: 2/16 N Dobson Rd Chandler AZ 85224

Number of Police 2 Number of Security Personnel [_]Fencing Csarriers
Must explain security measures: | Security guard stationed inside event checking ID's; 1 guard patrolling

to ensure alcohol remains on premise. Certified and experienced bartenders to dispense alcoho|

1, How is this special event going to conduct all dispensing, serving, and selling of spirituous liquors?
Check one of the following boxes. (R-19-318)

[lon-site consumption Clott-site (auction/wine/distilled spirits pull) [Jpoth

2. How many special event days have already been issued to this organization during the current year? 0

10/28/2025 Page 2 of 4
Inckviduo's requiting ADA accommodations please call (602)542-2999

SECTION 7

EVENT START EVENT END
TIME AM/PM TIME AM/PM

oav1 03/21/26 Saturday 5pm 11:59pm

DAYS DATE DAY OF WEEK

DAY 2

DAY 3

DA
“ REG

DAY 5
FEBUS 2026

MARICOPA COUNTY
DAY 7 CLERK BOARD OF SUPERVISORS

DAY 6

DAY 8

DAY 9

DAY 10

1. Is the Organization using the services of a DLLC approved Special Event Contractor from the list on our website?

[Wes no If yes, please provide the Name of the Special Event Contractor:

Special Event Contractor Signature:

2. Is the organization using the services of a series 6, 7, 14, or 12 licensee to manage the sale or service of alcohol?
(Licensees who hold a series 6, 7, 11, or 12 license are automatically qualified to be a special event contractor)

{Nes [41No if yes, Name of Licensee: Liquor License #:

3.List the name of the Organization/individual that will receive revenues:

Name; St Katherine Greek Orthodox Church Percentage: 100%
Address; 27 16 N Dobson Rd Chandler AZ 85224
Strect City State Zp
Name: Percentage:
Address:
Street city State Zip
Please read A.R.S. § 4-203.02 and R19-1-205 Special event license rules and Requirements.
10/28/2025 Page 3 of 4

Individuals requiting ADA accommodations please ca'l (602)542-2999

Licensed location diagram: The licensed premises for your special event is the area in which you are
authorized to sell, dispense, or serve alcoholic beverages under the provisions of your license.

Declaration:
1, (Print Name) _Evangelia Archuleta

authorized to submit this application. | have read the contents and to the best of myknowledge believe all statements
made on this application to be true, correct, and complete. Cy pf
Signature: 4

SPECIAL EVENT DIAGRAM AND

, declare under penaity of perjury that | am

SAFETY PLAN STANDARDS

Diagrams do not need to be overly complicated, they can be hand drawn. However, we
do not accept photographs or aerial views that do not show the premises clearly. The
diagram should clearly depict the special event area in relation to the entire premises.

Each diagram must include:
e Overview of the location
e The event area clearly outlined with black marker
e Where alcohol will be served/stored
e All entrances and exits
e Where security will be positioned
e Square footage of event area
e Show North, East, South, West

10/28/2025 page 4 of 4
Individua's requiring ADA accommodations please call (602)542-2999

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