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2. Requirements
   - Must be 18 - Must have completed a valid Responsible Beverage Server Course - All applications will be subject to a background check conducted by the Ashland Police Department - Please allow 5-7 business days for processing
3. License Expiration
   Licenses expire on June 30. When applying within a license year, the period may be shorter than a full year.
5. Original or Renewal Application? *

   1. Original Application (I do not currently have a license to serve in the City of Ashland)
   2. Renewal Application (I currently have an unexpired license with the City of Ashland)
6. Printable Version
   A printable version of this application can be downloaded here: https://www.coawi.org/DocumentCenter/View/1579/Operators-License-Application-01-2021
8. First Name*
9. Last Name*
11. Date of Birth*
12. Email
13. Phone Number*
15. Residential Address*
    Please include house number, street, city, state, and zip. Your license will be mailed to here unless you provide a separate mailing address.
16. Mailing Address (if different than residential)
18. Serving at:*
    List establishment(s) where you are serving. If applying for a temporary license, list the organization, event(s), and dates you are working.
20. License Type*
    -- Select One --One Year ($30.00)Two Year ($50.00)Provisional ($15.00)One Year applications after March 1st ($15.00)Temporary License ($5.00) (only for persons employed by or donating their services to nonprofit corporations)

    If applying after March 1st and before June 30, select "One Year applications after March 1st" for a prorated fee ($15.00).
21. Certificate of Responsible Beverage Server Training
    Upload a photo or copy your Responsible Beverage Server Training certificate.
23. Have you been convicted of or pled no contest to any felony or misdemeanor for violation of any federal law, any Wisconsin law, any laws of any other states or ordinances of any municipality; or are there any charges pending against you?*

    1. No
    2. Yes

    (If renewing, list only violations since date of your last application)
25. If yes, please state the nature of offense(s), nature of court(s), and date(s) of conviction.
27. By signing my name below, I hereby apply for a license to serve Fermented Malt Beverages and Intoxicating Liquors, subject to the limitations imposed by Section 125.32 (2) and 125.68 (2) of the Wisconsin Statutes and all acts amendatory thereof and supplementary thereto, and hereby agree to comply with all laws, resolutions, ordinances and regulations, Federal, State and Local, affecting the sale of such beverages and liquors if a license is granted to me. I hereby declare that I am a resident of the State of Wisconsin and that all of the above statements are true and correct.
29. Name*
31. Payment Options
    Payment can be made at City Hall (601 Main St W) via cash, check, or credit card. Make checks out to City of Ashland. Online payments can be made via Payment Services Network (PSN). Please note there is a service fee charged with each PSN payment.
32. Online Payment
    Payment Services Network
Leave This Blank:


34. 1. Receive an email copy of this form.
35. Email address

    This field is not part of the form submission.

36. Submit Submit and Print

* indicates a required field