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SelfExclusion Application
APPLICANT INFORMATION
Please read these instructions and the SelfExclusion Application Form, including the Terms and
Conditions, Release of Information and Acknowledgment
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How to fill out national gambling self exclusion

How to fill out national gambling self exclusion
01
Obtain the self-exclusion form from the national gambling regulatory authority.
02
Fill out your personal details such as name, address, date of birth, and contact information.
03
Specify the duration of the self-exclusion period (e.g., 6 months, 1 year, etc.).
04
Read and understand the terms and conditions of the self-exclusion program.
05
Sign and date the form to acknowledge your participation and agreement.
06
Submit the completed form to the national gambling regulatory authority either in person or by mail.
07
Keep a copy of the form for your records.
08
During the self-exclusion period, avoid all gambling establishments or online gambling platforms to ensure compliance.
Who needs national gambling self exclusion?
01
Individuals who wish to restrict their access to gambling activities and facilities.
02
Those who have experienced gambling addiction or want to prevent potential addiction.
03
People who want to have better control over their gambling habits and prevent financial losses.
04
Those who want to prioritize their personal well-being and mental health over gambling activities.
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What is national gambling self exclusion?
National gambling self exclusion is a program that allows individuals to voluntarily ban themselves from gambling activities in order to address issues with problem gambling.
Who is required to file national gambling self exclusion?
Individuals who believe they have a gambling problem and want to take steps to prevent further harm to themselves or others are required to file national gambling self exclusion.
How to fill out national gambling self exclusion?
To fill out national gambling self exclusion, individuals typically need to provide personal information such as name, address, date of birth, and details about their gambling history. This information can usually be submitted online or in person at a designated facility.
What is the purpose of national gambling self exclusion?
The purpose of national gambling self exclusion is to provide a tool for individuals to proactively address problem gambling by restricting their access to gambling facilities and resources.
What information must be reported on national gambling self exclusion?
Information such as personal details, relevant gambling history, and contact information are typically reported on national gambling self exclusion forms.
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