Apply for Membership

Company Information

Company Name(Required)

Representative - Name(Required)

First Last

Representative - Email(Required)

Company Website(Required)

Representative - Phone (Office)

Representative - Phone (Mobile)(Required)

Company Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Select the option that best describes your primary business:(Required)

Describe your Primary Business:(Required)

What is your company’s reason for joining IGSA?

Has your company or any of its officers, directors or principals ever been subject to a gaming license revocation or suspension investigation or proceeding in any jurisdiction?(Required)

Yes

If YES, provide a description of the proceeding, when it occurred, its current status or outcome and any other relevant information:(Required)

Do you have any reason to believe that if your company applied it may be denied a gaming license in any jurisdiction for any reason?(Required)

Yes

If YES, identify and fully describe the reason for such belief:(Required)

Does your company conduct gaming related business in any jurisdiction where gaming is not regulated by a governmental agency or where gaming is not subject to governmental licensure?(Required)

Yes

If YES, identify all such jurisdictions and the nature of the business your company conducts in such jurisdictions:(Required)

Apply for Membership

Join suppliers, operators and regulators in the only industry association creating standards for and by the gaming industry.

Company Information

Committee Participation

IGSA Entities and Dues

Payment Information

Notice & Signature