GoChain Registration
Please fill out this form to join the GoChain whitelist.
Email address *
Full Name *
Make sure this matches your ID
Your answer
Phone number *
Your answer
Telegram Username *
Your answer
Home Address *
Your answer
Date of Birth *
Make sure this matches your ID.
Nationality *
Please enter the full name of the country you are from.
Your answer
Country of Residence` *
Where you live right now.
Your answer
Ethereum Wallet Address *
Please fill in your Ethereum wallet address from which you plan to make your contribution.
Your answer
Requested Contribution Amount in Ether (ETH) *
Your answer
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