51�� agreement for outside food

URL

This field is for validation purposes and should be left unchanged.

Are you a 51�� community member (staff, faculty, or student with a G#)?*

Yes

Will all attendees at this event be 51�� community members (staff, faculty, or students with a G#)?*

Yes

No further form submission required. This is a private event. No external food form or temporary restaurant license is required. Please follow 51��’s private event food safety guidelines:

Refrigerate foods that spoil quickly within 2 hours (1 hour if outdoors or air temperature is above 90°F).
Keep hot foods above 135°F and cold foods below 41°F.
Use utensils or gloves – no bare hand contact with ready-to-eat foods.
Wash hands before handling food.
Label foods containing common allergens when possible.
Dispose of leftovers if food has been out longer than safe time limits.

Contact information and event details

Event organizer name*

Email*

Phone*

Event name*

Planning department or organization*

Date*

Estimated guest count*

Campus or center*

Building*

Room*

Food type

What type of food will be served? (select all that apply)*

Potentially hazardous foods (meats, dairy, cooked rice, cut fruit, cut vegetables, etc.)

Non-hazardous foods (candy, bottled beverages, pre-packaged snacks, store-bought desserts)

This event may not require a temporary restaurant license. 51�� Food Services will review your submission and confirm.

Description of food to be served*

As a reminder, home-cooked food cannot be served to the public.

Vendor or restaurant details

Restaurant name or vendor contact information*

Restaurant license, mobile unit license for a food cart, or catering license from the restaurant or vendor*

Accepted file types: pdf, Max. file size: 20 MB.

Copy of temporary restaurant license application submitted to the County Health Department*

Accepted file types: pdf, Max. file size: 20 MB.

Temporary restaurant licenses must be submitted to the county 14 days prior to the event.

Valid food handler card of person in charge at event*

Accepted file types: pdf, Max. file size: 20 MB.

Liability and food safety acknowledgment

Signature and submission

Full name*

This electronic signature is the legal equivalent of your handwritten signature.

Date*

We want the request process to be as smooth and straightforward as possible. If you have questions, need support, or want to share specific details, just reach out – we’re here to help.

Contact: foodservices-group@pcc.edu
Phone: 971-722-4316
Office hours: Monday – Friday, 7am-3pm

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