Request Access · Gambling Aotearoa

Request access to Gambling Aotearoa

Please use this form if you are a new society or club that wishes to gain access to Gambling Aotearoa. Your message will be sent to DIA who will assess your invitation request.

Society or club details

Society or club name

Incorporated society number if applicable

Company number if applicable

Primary phone number

Business address

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Postal address is different to business address

Why does your society or club want access to Gambling Aotearoa?

Your details

First name

Middle name

Last name

Date of birth

Email address

Primary phone number

Request access to Gambling Aotearoa

Society or club details

Physical address details

Postal address details

Your details