BitLumens Bounty KYC Form

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BitLumens Bounty KYC Form

All Bounty Participants must complete this form prior to any stakes being given for the BitLumens Bounty Campaign.

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* Indicates required question

First Name *

Your answer

Middle Name (optional)

Your answer

Last Name / Surname *

Your answer

Nationality/Citizenship *

Your answer

Bitcointalk Username *

Your answer

Bitcointalk Profile URL *

Your answer

Telegram Username *

Your answer

ERC20 Token Wallet Address (No Exchange Addresses) *

Your answer

Email Address *

Your answer

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