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Buying PAX Tokens With NEO
1. You must fill out this form for each time you purchase tokens.

2. By clicking to participate in this token sale, you are agreeing that you have read the legal disclaimer within the whitepaper and agree with all terms and conditions contained therein.

3. Restricted countries: People’s Republic of China, Afghanistan, Bosnia and Herzegovina, Central African Republic, Cuba, Democratic Republic of Congo, Democratic People’s Republic of Korea, Eritrea, Ethiopia, Guinea-Bissau, Iran, Iraq, Israel, Libya, Lebanon, Somalia, South Sudan, Sudan, Syria, Uganda, Vanuatu, Yemen. Citizens and residents of United States of America can participate only if they qualify as Accredited Investors. It is your responsibility to adhere to your country's rules and regulations.

What is your Email Address? Must be valid. *
Your answer
What is your Public NEO Address in which you are going to use to buy tokens from us? *
Your answer
What is your ETH Public Address (ERC20 token compatible wallet) where we can send PAX Tokens to?
Your answer
How much NEO are you using for purchasing PAX tokens for this transaction? (Please remember, minimum is 1 NEO per transaction)
Your answer
How many PAX Tokens are you buying? (You must fill this out for each time you buy tokens) *
Your answer
Did someone refer you? *
If you answered yes above, please provide the referrer's unique ID.
Your answer
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