Thank you for your interest in staying in touch with BitcoinCensus.

***Your e-mail address will be protected. It will never be sold or distributed. We will not spam you.***

We will make no effort to link data from this form to our other survey records.

Please provide us with your e-mail address and answer a few contact preferences.

Question Title

* 1. Please enter your e-mail address. Anonymous addresses (not containing your name) and personal accounts (hotmail, gmail, etc) are preferred.

Question Title

* 2. Please indicate your contact preferences (select all that apply).

Question Title

* 3. Please indicate your contact preferences (select only one option).