Entertainment Club Permit

Business Information
  1. (required)
  2. (required)
Give the following information for each individual, partner, or corporate/officer/director:
  1. ALL APPLICANTS: Have any of the applicants, applicants officers, directors, partners or any other person involved in the operation or management of the entertainment club ever been convicted or pled guilty to any criminal or motor vehicle offense in any court of law, including traffic tickets by mail or been convicted of a felony within the preceeding five years?
  2. If yes, please complete the following information:
  3. Is this a multi-use facility?
  1. List services agreed upon by sponsor and department head and any conditions imposed, in the appropriate block.

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