Register

We’re excited to partner with you and work together to support Nebraska’s skill game industry. To get started, please complete the online NOMA membership application below or download the membership application and mail a completed copy with payment to: NOMA, 1607 South Locust Street, Suite A, Grand Island, NE 68802.

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Organization Information

Legal Entity Name*

DBA (if any)

Primary Contact Name*

Title*

Email*

Phone*

Billing Address*

Street Address City State ZIP Code

Nebraska DOR License/ID (if applicable)

Website

Membership Type

Membership Type*

Operator (owns/operates Skill Game machines in Nebraska)

Vendor/Manufacturer (manufacturer, distributor, supplier)

Dues Calculation & Billing Frequency

OPERATOR MEMBERS: 1-99 Machines ($15 per machine annually)

Price: $15.00

Select the number of machines in the Quantity field to calculate annual dues at the rate of $15 per machine

OPERATOR MEMBERS: 100+ Machines ($10 per machine annually)

Price: $10.00

Select the number of machines in the Quantity field to calculate annual dues at the rate of $10 per machine

VENDOR/MANUFACTURER MEMBERS

If you are a vendor or manufacturer, select fee from drop down to populate total annual dues

Total Annual Dues

Preferred Billing Frequency

Annual

Semi-Annual

Note: Machine counts may be cross-checked against Nebraska Department of Revenue records for accuracy.

Register

Organization Information

Membership Type

Dues Calculation & Billing Frequency

Acknowledgments & Agreements