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Profile Update

This form is for GamLEARN members to update their profile.

If you are not yet a member, please submit the joining form here

    First Name:

    Surname:

    Email Address:

    Contact Telephone Number:

    Region:

    If you selected Other, please specify here:

    Gender:

    Age:

    Do you have lived experience of gambling related harm?

    If you answered Yes, how would you define your experience?

    Please state how you would self-define yourself:

    If you answered Professional Worker, please specify. Tick as many as apply.

    If you selected Other, please specify here:

    Please tell us why you would like to become a GamLEARN member. Tick as many as apply.

    If you selected Other, please specify here:

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