Research iGaming – Community Impact Partner Application
Complete this 3-section application to share your organisation details, community work, and the support you need.
Section 1 – About Your Organisation
Organisation Name
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Country
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Province / State / Region
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City / District / Community
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Does your organisation operate in other Provinces / States / Regions?
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Yes
No
If yes, please list them, If no, N/A
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Website or Social Media Page
Contact Person's Name
*
First Name
Middle Name
Last Name
Email Address
*
example@example.com
Contact Number
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-
Country Code
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Area Code
Phone Number
Section 2 – Your Work & Community
What best describes the work you do?
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Education
Youth Development
Youth Sports
Arts, Culture & Heritage
Health & Wellbeing
Cancer Support & Awareness
Food Security
Clean Water & Sanitation
Skills Development & Employment
Technology & Digital Inclusion
Environmental Protection
Marine & Wildlife Conservation
Responsible Gambling & Harm Prevention
Community Development
Other
Briefly tell us what your organisation does.
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Approximately how many people did your organisation directly support in the last 12 months?
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Who do you primarily serve?
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Children
Young People
Adults
Families
Elderly People
People with Disabilities
Patients / People Affected by Health Conditions
Unemployed People / Job Seekers
Schools / Students
Communities
Other
Do any of your programmes directly involve children under 18?
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Yes
No
Section 3 – What Support Do You Need?
What do you currently need funding or support for?
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Approximately how much funding do you need?
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Approximately how many people would benefit from this funding or support?
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What type of support would help you?
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Financial Funding
Food / Essential Supplies
Educational Resources
Sports Equipment
Medical / Health Support
Technology / Devices
Infrastructure / Facilities
Professional Expertise
Volunteers
Other
What would this funding or support help you achieve?
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Would your organisation be open to receiving support from companies operating within the regulated gaming and iGaming industry?
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Yes
No
I would like more information
Declaration
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I confirm that the information provided is accurate and understand that Research iGaming may contact us for additional information if our organisation progresses to the next stage.
Please verify that you are human
*
Submit
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