Applicant Information:

Date:

Department/Organization: *

Name of Applicant: *

Address: *

Phone: *

Fax: *

E-Mail: *

Event Information:

Event Date: *

Event Location: *

Event Description: *

Event Times: *
Start: - End:

Number of Guests: *

Total Estimated Cost of Food & Beverage: *

(If the estimated cost for catering changes +/– 10% after this Waiver is submitted, a new Waiver application must be competed and returned to the Event Planning Office.)

Reason for Waiver Request: *

(Waivers will not be approved based on source of funding.)

Name of Prospective Caterer: *