Free Membership Form
Thank you for supporting us and this project!

Complete the form below and you will be able to send, receive and request unlimited customized kind and empowering messages. Your information is private. The messages you send will be sent to those that need them. We will use the information you provide here to customize the messages that others send in, and are sent to you. Your phone number is never shared. You can request a message at any time.
Together, we can scale all natural happiness, using the power of technology.

MD
Connection Doctor, Chibur
&
Courtney Val
Founder, Valent

Looking for our FAQs? You will find them here: https://docs.google.com/document/d/1KIfhtVmjM8TvtCTxUwrXbkd2R3UIeeF3XDjKbXArWQM/edit?usp=sharing
Email address *
What is your mobile phone number? *
Your answer
Who is your cell phone provider? *
For example, Verizon, T-mobile
Your answer
Do you have the mobile application WhatsApp? *
For this testing phase of Project IB, you must have WhatApp installed on your phone. To download it please go here: https://www.whatsapp.com/download/
Project IB only works if people send messages in for us to send to others randomly. Can you help? Tell us, what is something that you need to hear right now? Imagine yourself standing in a room with your eyes closed. Someone you care about whispers something in your ear that they know you need to hear. What did they say?
We will send this message out right away! Thank you!
Your answer
Which of the following categories apply to you? *
Required
Comments, anything else we should know about you?
Your answer
Terms & Conditions: By clicking yes to this question you agree to receive messages from us, standard messaging rates will apply. To cancel just send a message asking to cancel. *
Submit
Never submit passwords through Google Forms.
This form was created inside of Chibur. Report Abuse