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2. This form may be used for RENEWALS only. New operators/bartenders must submit applications in person at Lisbon Village Hall.

   The license year runs from July 1st through June 30 each year. Applications will be reviewed/processed beginning 60 days before expiration, and licenses will be mailed and/or available for pickup at Village Hall beginning in mid-June.

   If you are applying after July 1st:
   Please allow a minimum of 3-5 business days after submittal for Village Staff to process your renewal license.

4. First Name*
5. Middle Name*

   If no middle name, enter "none"

6. Last Name*
8. Date of Birth*
   Date of Birth
9. Gender*

   1. Male
   2. Female
10. Do you have a current license in Lisbon?*

    1. Yes
    2. No
11. Current License No.*
13. Current Place of Employment Using License*
15. Address*
16. Address Line 2
18. City*
19. State*
    -- Select One --AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific
20. Zip Code*
22. Phone*
23. Email*
24. Confirm Email*
26. Have you ever been arrested, cited or convicted of charges related to activities performed while bartending?*

    1. Yes
    2. No
28. If you answered "Yes," please give date(s) and details:
30. Have you had any arrests, charges, or citations related to controlled substances, disorderly conduct/battery, or involving alcoholic beverages?*

    1. Yes
    2. No
32. If you answered "Yes," please give date(s) and details:
34. Have you been convicted of a felony?*

    1. Yes
    2. No
36. If you answered "Yes," please give date(s) and details:
38. List all arrests, convictions, dismissals and pending cases within the last twelve (12) months (do not include speeding and parking violations).*

    Please note: Failure to list all matters truthfully will result in the rejection of this application. A complete background check will be completed and compared to the information you provide on this application.

40. How will you pay the $37.00 annual license fee?*

    1. Online with Credit Card (4% service fee)
    2. Bring cash/check/cc payment to Village Hall
    3. The $37.00 check is in the mail
41. How would you like to receive your license?*

    1. Please mail to my home address
    2. I will pick it up at Village Hall

43. Thank you for using our online Operator License Application. Once you click submit, you will be taken to our online payment portal (AllPaid) to pay the fees online. Simply close the browser, if you're mailing a check or paying in person at Village Hall. Your application will be processed in the order it was received. Once the application/fee is received, the license will be mailed to you.

Leave This Blank:


45. 1. Receive an email copy of this form.
46. Email address

    This field is not part of the form submission.

47. Submit

* indicates a required field