Town of Mocksville

Kenneth W. Gamble, Town Manager / 171 S. Clement Street / Phone – 336-753-6701 / Fax – 336-751-9187


Application for Electronic Gaming License

Please complete and sign the form below:

Electronic Gaming License Application

Town of Mocksville’s Application for an Electronic Gaming License.

  • By checking the consent box and signing below I attest that the answers to these questions and my statements are true to the best of my knowledge and belief. I also agree and consent to a criminal history background check to be completed by the Davie County Sheriff’s Office. Please sign with a touch screen, stylus, or using your mouse.
  • Provide a complete statement of all convictions of any person whose name is required to be given above for any felony, or gambling or any violation of the law relative to gambling.
  • Provide a complete statement of any revocation by any governmental unit, of any license to operate an electronic gaming establishment held by any person whose name is required to be given above.
  • Provide a complete statement of any conviction of any person whose name is required to be given above for violation of any statute, law, article or regulation of any government concerning the operation of an electronic gaming establishment.
  • The name and address of any electronic gaming establishment or other establishment owned or operated by any person whose name is required to be given above wherein the business of electronic gaming establishment is carried on.
  • A description of any other business to be operated on the same premises or on adjoining premises owned or controlled by the applicant.
  • If food and beverages are served at the establishment, they meet the requirements of the Davie County Health Department, including any and all necessary permits and/or licenses.
  • The establishment is a minimum of (1,000) feet from any schools, daycare, religious institutions, parks, and buildings being used as a dwelling.
  • The establishment is a minimum of ½ mile away from any other establishment engaged in an electronic gaming operations business.
  • The electronic gaming operations are not in or as part of any check-cashing facility.
  • All game rooms/tables/devices are operated only on the ground floor of a building.
  • There are no screens, curtains, blinds, or other obstructions placed between the windows or the entrance to the room where the electronic gaming is played and the rear wall of the room. A clear view of the interior from the entrance to the rear of the room is maintained at all times.
  • There are no partitions forming rooms, stalls, or other enclosures in the public areas. This requirement is not constructed to prohibit the maintenance of closets used exclusively for storage purposes, or of toilets.
  • There are no open or secret connections through doors, windows, trap doors, hidden doors, panels, stairways, or any other devices with any place where gambling can be conducted or where people meet or congregate for immoral purposes.
  • License Required

    The person maintaining and operating the electronic gaming operation has first secured a Zoning Permit from the Davie County Planning Department to do so.

    The person maintaining and operating the electronic gaming operation has secured a license from the Mocksville Town Manager to do so.

    The license shall expire on June 30th every year. The licenses shall not be transferable.

    A license shall not be issued to any person who is not a citizen and resident of the state.

  • License Form and Content Display

    Every license issued to this pursuant to this article specified the premises for which it is issued, the number of tables or games or devices to be operated thereunder, the name of the owner or operator, and the dates upon which the license begins and expires.

    The license is posted in a prominent place on the premises at all times.

    Licensee Responsible for Agents and Employees -The acts and conduct of the agents and employees of the licensee in the conduct of the business shall be deemed to be the acts and conduct of the licensee.

    License Revocation -A conviction of a licensee’s agents or employees, for any violation of any provision of this article, shall by operation of law constitute an automatic revocation of the license. In addition, the Town may, at any time, for cause and after a hearing of which the licensee shall be given reasonable notice, the Town may revoke any license issued pursuant to this article.