BurstIQ Articles, Video and Mass Media Bounty Registration Form
Bounty Allocation: 30% of total bounty program

Activities & Stakes:
- Base Stakes:
+ 50 stakes for <200 word article in any language or >1 minute video
+ 75 stakes for 200-500 word article in any language or 1-3 minute video
+ 100 stakes for >500 word article in any language or >3 minute video
- Bonus Stakes for Visibility:
+ 10 stakes for 200-500 visits or views
+ 30 stakes for 500-3000 visits or views
+ 50 stakes for 3000-10,000 visits or views
+ 100 stakes for >10,000 visits or views

How to Participate:
- Write an article, create a video or generate other relevant content for distribution on your blog or a mass media site
- Fill out this form
- Check to make sure you are listed in this table: https://goo.gl/bBsDHR

Restrictions:
- Articles and other content that do not relate directly to BurstIQ, are negative in tone, or are of substantially poor quality will be disqualified.
- Content must include a link to http://www.burstiq.com/biq-token-crowdsale/
- If visits or views cannot be verified an external party, you will receive only the Base Stake

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 *
Your answer
Bitcointalk Profile Link *
Your answer
Forum Rank *
Your answer
Link to your Article or Video *
Your answer
E-mail *
Your answer
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.
Your answer
Submit
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