Gaming Suppliers Membership Form

Name of Company *

Company Description *

0/150

Company Website URL

Address *

Phone Number *

Billing Name *

First Name Last Name

Title or position *

E-mail *

Annual Fee-CDN Dollars	Basis of Dues - Global Annual Revenue
$50,000	Greater Than $750 Million	Includes: Licensed suppliers of gaming machines and tables Gaming systems and related technology
$35,000	$250 Million to $749 Million
$15,000	$50 Million to $249 Million
$7,500	Less Than $50 Million