Join GSA


Download the North American Jurisdiction application or the Europe Jurisdiction application and email to sec@gamingstandards.com or complete the online application below. Please contact us at sec@gamingstandards.com or (510) 492-4060 for additional information.

Note that fields that are required are identified by an asterisk (*).

Company Information 
* Company name: Zip:
* President / CEO: Country:
* E-mail: Phone:
Company address: Web site:
City:    
State:    
If your company is publicly traded, and you give permission to GSA to use your ticker symbol in GSA press releases, list it here:
* Check the box that best describes your primary business: Manufacturer   Operator  
Other  
What is your company’s reason for joining GSA?
* 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?
YES NO

Provide a description of the proceeding, when it occurred, its current status or outcome and any other relevant information:
* 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?
YES NO

Identify and fully describe the reason for such belief:
* Does your company conduct gaming related business in any jurisdiction where gaming is not regulated by a governmental agency or were gaming is not subject to governmental licensure?
YES NO

Identify all such jurisdictions and the nature of the business your company conducts in such jurisdictions:
 
  Membership Class and Fees
Platinum ($89,320)
Gold ($44,660)
Silver ($22,330)
Bronze ($11,165)
Operator Committee ($5,000)
GSA membership and standard licensing is based upon a calendaryear billing cycle. Applications received after July 1 will be prorated to 50% of the annual fee, providing company agrees to renew membership for the next calendar year at same or higher level. Bronze membership is not eligible for prorating. All fees are in US Dollars and dues will be aligned with US CPI.
 
  Notice

Applicants agree for the duration of the applicant’s membership in GSA to fully abide by GSA bylaws, policies, rules and regulations as such can be amended from time to time hereafter. Member understands that GSA does not guarantee the availability and/or terms of any licensing agreements with third parties regarding proprietary specifications.

Applicants are notified that they must immediately make any applicable patent declarations in accordance with GSA patent policy 103 upon approval of this application with the exception of Operator only committee members.

Applicant agrees to provide a minimum of 60-days notice prior to their renewal date should they elect to terminate membership.

* Name: * Date:
* Title: * Electronic Signature:

Application must be signed before it can be processed.

GSA membership decisions are, in large part, premised and reliant upon the accuracy of the information supplied by the applicant. By submitting this application, the applicant represents that the information contained herein is truthful and complete to the best of its knowledge.

 
Representatives Information
PRIMARY REPRESENTATIVE
* Name: Zip:
* Title: Country:
* E-mail: Phone:
Address: Cell:
City: Web site:
State:    
MARKETING REPRESENTATIVE
Name: Zip:
Title: Country:
E-mail: Phone:
Address: Cell:
City: Web site:
State:    
TECHNICAL REPRESENTATIVE
Name: Zip:
Title: Country:
E-mail: Phone:
Address: Cell:
City: Web site:
State:    
 
Payment Information 
A check payable to Gaming Standards Association is enclosed
Wire transfer (add 25$)
Charge fee to the credit card indicated below
PLEASE NOTE: There will be a 5% service fee added to all credit card charges. In completing the credit card form, you are agreeing to the additional 5% service fee.