BitPesa Online Opportunities with Bitcoin Seminar Application Form

JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.

Welcome to the BitPesa Online Opportunities with bitcoin seminar. The goal of the seminar is to explore various business opportunities the World's first global currency is enabling both offline and online. Are you interested in exploring new exciting opportunities? Fill in this form and get invited to one of our seminars coming near you.

Email Address: *

First Name *

Last Name *

Mobile Number *

e.g. +254 725 274191 incl Country Code.

Gender? *

Male

Female

How old are you? *

20-29

30-39

40-49

50-59

60+

Do you trade on the Nairobi Stock Exchange. *

Do you trade on Forex Exchanges. *

Choose the town nearest to you. *

Have you heard of Bitcoin *

Have you used Bitcoin *

What is your type of organization or business? *

Academic/University

Banking/Financial Services

Consulting/Advisory

Investment Fund

Media

Non-Profit/NGO

Social Enterprise

Small & Medium sized Enterprise

Other:

Which financial services do you use here in Kenya? *

Please check all that apply.

Airtel Money account

M-PESA account

M-Shwari account

Barclay's bank account

CBA bank account

Chase bank account

Equity bank account

I&M bank account

KCB bank account

Standard Chartered bank account

Visa credit card

MasterCard credit card

PayPal

Other:

Required

Any other feedback or suggestions?

Let us know what you think about BitPesa, Bitcoin and any other thoughts...

Submit

Clear form

Never submit passwords through Google Forms.

This form was created inside of B Transfer Services Limited.

Does this form look suspicious? Report

Forms