Charitable Games Applications

Access applications by filling out the form below, selecting your desired forms and then clicking the submit button.


I will download my desired applications and submit for consideration.
I would like to meet with a Charitable Games Representative
I would like to have an information seminar
I would like to have information mailed

Organization Information
* Organization Name:
* Phone Number:
* Address 1:
Address 2:
* City:
* State:
* Zip:

Tax Exempt Status
Contributions to our organization are tax deductible by Donors

Contact Person's Information
* Contact Person's First Name:
* Contact Person's Last Name:
* Phone Number:
If YOUR mailing address differs from the Organization's address enter it here
Address 1:
Address 2:
City:
State:
Zip:
Email Address:

Which type of Charitable Gaming License are you interested in?
* Check all that apply
Bingo – Regular (License for 1 year)
Bingo – Limited (License for 72 hours/Short-term License)
Raffle
Monte Carlo Night Party/Texas Hold'em'
Supplier

Winning Numbers

Where To Play

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