BurstIQ Twitter Bounty Registration Form

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Bounty Allocation: 10% of total bounty program

Activities & Stakes:
>250 followers : 1 stake for each new tweet or retweet
>750 followers : 2 stakes for each new tweet or retweet
>1,500 followers : 5 stakes for each new tweet or retweet
>10,000 followers: 10 stakes for each new tweet or retweet

How to Participate:
- Fill out this form
- Check to make sure you are listed in this table: https://goo.gl/a3BTHq
- Follow @BurstIQ

Restrictions:
- Negative or non-substantive tweets will not be counted
- Tweets must include #burstIQ, #biqtoken, or @burstiq
- Stakes are capped at 20 tweets / retweets per week

Answers provided below will be independently verified. If answers provided below are found to be substantially different from the independent verification, you will be disqualified from the program.

Bitcointalk Username *

Bitcointalk Profile Link *

Forum Rank *

Twitter Account URL *

Number of Followers *

E-mail *

ETH address for receiving bounty *

IMPORTANT: You must use an ERC20 compatible ETH address (such as MyEtherWallet, Parity, Mist, etc.). Do not submit ANY non-ERC20 Exchange address - if you do, your tokens will be lost and we will not resend them.

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