Startup Application Form
First Name *
Your answer
Last Name *
Your answer
Name of Startup *
Your answer
Business Sector
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Website
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Title (Position) *
Your answer
Number of Employees *
Your answer
Year of Operations *
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Funding Stage *
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Current Revenues *
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Current Status *
Country *
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Address of Startup
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Post/Zip Code
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E-mail *
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Phone Number *
Your answer
On top of the above information, we would like you to give us some more information in regards to the current situation of your startup. This would allow us to estimate the most fair price, to make sure that everyone can access our services, and pose no barriers for the development of Blockchain
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