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Business Email

First Name

Last Name

Company

Job Title

Business Phone (incl. international code)

Mobile

Country United States Canada Afghanistan Albania Algeria American Samoa Andorra Angola Anguilla Antarctica Antigua and Barbuda Argentina Armenia Aruba Australia Austria Azerbaijan Bahamas Bahrain Bangladesh Barbados Belarus Belgium Belize Benin Bermuda Bhutan Bolivia Bosnia and Herzegovina Botswana Brazil British Indian Ocean Territory British Virgin Islands Brunei Bulgaria Burkina Faso Burundi Cambodia Cameroon Cape Verde Cayman Islands Central African Republic Chad Chile China Christmas Island Cocos (Keeling) Islands Colombia Comoros Congo Cook Islands Costa Rica Croatia Cuba Curaçao Cyprus Czech Republic Côte d’Ivoire Democratic Republic of the Congo Denmark Djibouti Dominica Dominican Republic Ecuador Egypt El Salvador Equatorial Guinea Eritrea Estonia Ethiopia Falkland Islands Faroe Islands Fiji Finland France French Guiana French Polynesia French Southern Territories Gabon Gambia Georgia Germany Ghana Gibraltar Greece Greenland Grenada Guadeloupe Guam Guatemala Guernsey Guinea Guinea-Bissau Guyana Haiti Honduras Hong Kong S.A.R., China Hungary Iceland India Indonesia Iran Iraq Ireland Isle of Man Israel Italy Jamaica Japan Jersey Jordan Kazakhstan Kenya Kiribati Kuwait Kyrgyzstan Laos Latvia Lebanon Lesotho Liberia Libya Liechtenstein Lithuania Luxembourg Macao S.A.R., China Macedonia Madagascar Malawi Malaysia Maldives Mali Malta Marshall Islands Martinique Mauritania Mauritius Mayotte Mexico Micronesia Moldova Monaco Mongolia Montenegro Montserrat Morocco Mozambique Myanmar Namibia Nauru Nepal Netherlands New Caledonia New Zealand Nicaragua Niger Nigeria Niue Norfolk Island North Korea Northern Mariana Islands Norway Oman Pakistan Palau Palestinian Territory Panama Papua New Guinea Paraguay Peru Philippines Pitcairn Poland Portugal Puerto Rico Qatar Romania Russia Rwanda Réunion Saint Barthélemy Saint Helena Saint Kitts and Nevis Saint Lucia Saint Pierre and Miquelon Saint Vincent and the Grenadines Samoa San Marino Sao Tome and Principe Saudi Arabia Senegal Serbia Seychelles Sierra Leone Singapore Slovakia Slovenia Solomon Islands Somalia South Africa South Korea South Sudan Spain Sri Lanka Sudan Suriname Svalbard and Jan Mayen Swaziland Sweden Switzerland Syria Taiwan Tajikistan Tanzania Thailand Timor-Leste Togo Tokelau Tonga Trinidad and Tobago Tunisia Turkey Turkmenistan Turks and Caicos Islands Tuvalu U.S. Virgin Islands Uganda Ukraine United Arab Emirates United Kingdom United States Minor Outlying Islands Uruguay Uzbekistan Vanuatu Vatican Venezuela Viet Nam Wallis and Futuna Western Sahara Yemen Zambia Zimbabwe

Which best describes your role in the purchasing decision making process? Final Decision Maker Part of Final Decision Making Group Influence/Recommend No Role

Which of the following best describes the area of gaming you are in? Affiliate Affiliate Network (intermediary between affiliates and affiliate programs) Affiliate Program (part of an operator's affiliate program) Association Media/Press Operator (team involved in offering betting / games / slots to consumers) Regulator / government department Supplier (product, technology or service) Other (please specify in English)

What channel accounts for the majority of your gaming revenue? Landbased Online

Which of the following gaming types/verticals are you involved in? BingoCasinoCoin op/AmusementsEsportsFantasy sportsFinancial TradingLotteryPokerSkills gamesSocial GamesSports BettingStreet (Soft/low payout)TribalHospitality

Are you interested in sponsorship or exhibiting opportunities at: ICE Asia (Manilla, Philippines)ICE North America (New Orleans, Louisiana, USA)ICE Africa (Johannesburg, South Africa)Gaming Latin AmericaSports Betting USA (New York, USA)iGB Live! (Amsterdam, Netherlands)iGB Affiliate London (UK)iGB Affiliate Amsterdam (Netherlands)iGB Affiliate Berlin (Germany)

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Business Communication Information I confirm that the contact information I have given is for the purpose of business communications

Privacy Policy I confirm that I have read and accept the privacy policy

Comments

* If I have provided a non-business domain email address (such as, but not limited to, gmail, hotmail, etc) I am doing so in the context of it being used for my business and not personal interactions with Clarion.

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