Forms
Please use the links below to access forms related to land-based Poker Rooms, Electronic Gaming Devices, and Raffles that are licensed by the Kahnawà:ke Gaming Commission.
*NOTE: Our office hours are: Monday to Friday 8:30 AM to 4:00 PM – CLOSED FOR LUNCH FROM 12:00 PM TO 1:00 PM.
Electronic Gaming Devices
The forms accessible from this page are required for applications and renewals of Electronic Gaming Devices Licences and for other matters related to Electronic Gaming Devices that are licensed and regulated by the Commission. For your convenience, they can now be filled out and printed.
Full Disclosure Assurance Form
Release and Waiver of Liability Form
Criminal Record Information – Consent Form and Privacy Waiver
Schedule A – Application for Operator’s License
Schedule B – Business Entity Information Form
Schedule C – Personal Information Form
Schedule D – Application for Key Person Permit
Schedule E – Request to Temporarily Close
Schedule F – Material Change Report
Schedule G – Renewal Application
Schedule H – Comprehensive Self-Exclusion Request (English)
Schedule H – Comprehensive Self-Exclusion Request (French)
Schedule I – Request to Revoke (English)
Schedule I – Request to Revoke (French)
Schedule J – Registration of a Supplier Form
Schedule K – EGD Location Suitability
Poker Rooms
The forms accessible from this page are required for applications and renewals of Poker Room Licences, Dealer Permits and Key Person Permits – and for other matters related to Poker Rooms that are licensed and regulated by the Commission.
Full Disclosure Assurance Form
Criminal Record Information – Consent Form and Privacy Waiver
Applicable Fees
Schedule A – Application For Poker Room Licence
Schedule B – Business Entity Information Form – Previously repealed on 25 Onerahtókha / April 2012 is hereby reinstated and replaced
Schedule C – Personal Information Form
Schedule D – Business Entity Information Form – Repealed 14 Tsothohrkó:wa/January 2026
Schedule E – Personal Information Form – Repealed 14 Tsothohrkó:wa/January 2026
Schedule F – Key Person Permit Application
Schedule G – Dealer Permit Application
Schedule H – Renewal Application
Schedule I – Written Request for Special Events License
Schedule J – Approved Games – Previously repealed on 26 Enníska/February, 2014 is hereby reinstated and replaced 14 Tsothohrkó:wa/January 2026
Schedule K – Comprehensive Self-Exclusion Request
Schedule K – Comprehensive Self-Exclusion Request (French)
Schedule L – Request to Revoke
Schedule L – Request to Revoke (French)
Schedule M – Request to Temporarily Close
Schedule N – Material Change Report
Schedule O – Request to be Declared Dormant
Raffle Forms
The forms accessible from this page are required for an application for a Raffle Authorization – and for other matters related to any Raffle that is licensed and regulated by the Commission.
Schedule A – Application for Raffle Authorization
Schedule B – Compliance Agreement
Regulations Concerning Raffles
Frequently Asked Questions Raffles