2. Operator's (Bartenders/Sales Clerks) License Application
4. Fee Information
   Fee is $30.00 and includes a background check. The fee is non-refundable and is not prorated. Credit/debit card payments are accepted with a small convenience fee. If paying by check, make checks payable to the City of Delafield.
6. SECTION 1: APPLICATION TYPE
8. Application Type*

   1. New
   2. Renewal
   3. Provisional License (additional fee of $15)
   4. Temporary ($10.00)

   Please note the license may take up to 30 days pending a background check.
10. SECTION 2: APPLICANT INFORMATION
12. First Name:*
13. Middle Initial:*
14. Last Name (include suffix Sr, Jr, etc):*
16. List any other names by which you have been known on official records:
17. Date of Birth:*
    Date of Birth:
19. Home Street Address:*
20. City, ST Zip:*
22. Applicant Email Address:*
    You must include an email address. No mailed licenses will be sent.
23. Phone Number:*
25. Driver's License Number/State ID #:*
26. State Issued:*
28. UPLOAD A COPY OF YOUR DRIVER'S LICENSE OR STATE ID
30. SECTION 3: EMPLOYER INFORMATION
32. Place of Employment:*
    If you do not have a place of employment, type "N/A"
33. Phone Number of Business:*
    If you do not have a place of employment, type "N/A"
35. Manager Name:
    If you do not have a place of employment, type "N/A"
36. Manager Email:
    If you would like a copy also sent to your manager, please include their email here.
38. SECTION 4: WISCONSIN RESPONSIBLE BEVERAGE SERVER TRAINING COURSE OR PREVIOUS LICENSE INFORMATION
40. I CERTIFY THAT, I have (choose one)*

    1. held a retail license, manager’s or operator’s license within the past two years
    2. have completed the Responsible Beverage Server’s Training Course
    3. have enrolled in the Responsible Beverage Server’s Training Course

    Proof of a previous license or servers training course is required to be submitted. This requirement is NOT REQUIRED for renewal or temporary license applicants.
41. Upload a copy of your WRBST Course or previous license documentation
43. SECTION 5: OPERATOR'S LICENSE LAWS
45. Delafield Municipal Code
    Municipal Code Section 125.17 Issuance of Operators license
47. Department of Revenue Operator License Brochure
    https://www.revenue.wi.gov/DOR%20Publications/3104OperatorsLicenses.pdf

    Please review. If you need to complete the online beverage service courses, a list is provided through the brochure.
49. SECTION 6: TEMPORARY LICENSEES ONLY
51. What is a temporary operator's license?
    Temporary operator's licenses are issued to persons employed by or donating their services to a nonprofit corporation who is turn has been issued a Temporary Class B license for an event. The temporary operator's licenses are good for the duration of the event, not to exceed 14 days. Applicants are limited to two such licenses in a year.
53. Is this part of an event?

    1. No
    2. Yes
54. If yes, what event?
55. Event Start Date:
    Event Start Date:
56. Event End Date:
    Event End Date:
58. SECTION 7: CERTIFICATION
60. Required*

    1. I DO HEREBY

    make application for an operator’s license, to dispense alcoholic beverages on premises requiring a retail Class A, Class B, or Class C license, all subject to provisions of and limitations imposed by Wis. Stats. Ch. 125 and Delafield Municipal Code - Ch. 4.
62. Required*

    1. I DECLARE UNDER PENALTY OF LAW

    that all of the above information is true and correct to the best of my knowledge and belief. Incomplete, incorrect, or false information may lead to denial or revocation of this license. Any person who knowingly provides materially false information on an application may be required to forfeit up to $1,000.
Leave This Blank:


64. 1. Receive an email copy of this form.
65. Email address

    This field is not part of the form submission.

66. Submit

* indicates a required field