1. General information about the individual or organization

Name *

National Personal ID or Tax ID Number *

Address (Country, City/Town, Street address or P.O. box number) *

Phone number *

Email * (required)

Website

Contact person * (name and position)

2. Information about the activity or purpose

Mission and main activities of the organization or personal purpose of the individual *

Upload all documents that demonstrate the legitimacy of the organization or individual and the legality of the purpose or goal. Please include multiple documents in a zip file.

Copy of the certificate of incorporation, Articles of Association, personal ID document, passport and similar documents attesting the legitimacy and existence of the person or organization *

Documents attesting the need specified in the campaign such as medical, educational, corporate, and other documents as well as any other document that may contribute to demonstrating the legality and existence of the goal *

Additional information regarding the organization or goal

3. Information about the campaign

Name *

Description and purpose *

Image or logo *

Financial goal in Bitcoin currency (enter zero if the goal does not have a financial limit) *

Deadline of the campaign (leave empty if the campaign does not have a time limit)

Category of the campaign (choose one or more categories that apply to your campaign) *
BusinessCharityEducationOther

5. Declaration *

I declare that:
• The information in this form is complete and correct.
• At the time of signing of this form, individuals from the governing bodies of the organization have no pending pre-trial proceedings.
• During the communication campaign, the messages and images used comply with national and international provisions regarding the respect for human dignity, human rights, gender, religions, different ethnic groups.
I accept