Temporary Operator (Bartender) License Application

2. Temporary Operator (Bartender) License Application

   This license has to be approved by the Common Council. Please allow background check and Common Council approval time. Recommended - 45 days.

   This license has to be approved by the Common Council. Please allow background check and Common Council approval time. Recommended - 45 days.

3. 1. This is part of an Event Packet
   2. This is NOT part of an Event Packet

5. Type*

   1. New
   2. Renewal
   3. Temporary ($10)

7. Name*

   First, M.I., Last

8. Date of Birth*
   Date of Birth

10. Address*

    Street

12. City*

13. State*

14. Zip*

16. Driver's License*

17. Copy of Current Driver's License*

19. Email Address*

20. Phone Number*

22. Name of Business*

23. Phone Number of Business*

25. Have you Completed and Passed the Wisconsin Responsible Beverage Server Training Course?*

    1. Yes, please attach the Certificate of completion to your application
    2. No, visit http://www.learn2serve.com/wisconsin-beverage-server/

    Server's Training Course NOT required for Temporary License Applicants

26. If yes, upload a copy of your Responsible Beverage Documentation

28. Have you ever been issued a Liqour or Operator's License before?*

    1. Yes
    2. No

29. If yes, upload a copy of your license.

31. Has any such license or any application for such license ever been any of the following?*

    1. Revoked
    2. Denied
    3. Withdrawn
    4. Suspended
    5. None of the above

32. If any are checked, give date(s) and municipality where occured

    Date/Municipality

34. Event Name

    If part of an Event Packet

35. Start Date of Event
    Start Date of Event

36. End Date of Event
    End Date of Event

38. 1. N/A for an Event

40. I, the undersigned, do hereby respectfully make application to the local governing body of the City of Delafield, County of Waukesha, Wisconsin, for an "Operator's" license as provided by Section 125.17 of the Wisconsin Statutes, for the licensing year ending June 30, 2018. I certify that I am eighteen years of age or older. I am familiar with the laws, ordinances and regulations and I hereby agree if granted said license, to obey all provisions of said laws. I understand that all of my answers on this information sheet will be considered in connection with my license applications. I also understand that all answers herein are made under oath, and that false swearing is a crime as defined in Section 939.12 of the Wisconsin Statutes. Licenses may be revoked by the Common Council if the licensee violates the law or if he or she fails to comply with state statutes or city ordinances, or if any answers contained in the application or in this information sheet are false. I understand incomplete and incorrect information may lead to the denial of this license.

42. By Submitting this form, you have read and understand the information in this application and will adhere to all rules and regulations set forth by the City of Delafield.

44. Municipal Code Section 125.17 Issuance of Operators license

48. Applicant's Checklist

    1. Completed and submitted application
    2. Copy of current Driver’s License attached
    3. Fee – cash or check accepted. Please make check payable to City of Delafield.
    4. Responsible Beverage Server Training Course Certificate of Completion. (Not required for Temporary License Applicants)

Leave This Blank:


50. 1. Receive an email copy of this form.
51. Email address

    This field is not part of the form submission.

52. Submit

* indicates a required field