Full name (required) Your Email (required) Institution/Organization (required) Select your country (required) AfghanistanAlbaniaAlgeriaAndorraAngolaAntigua & BarbudaArgentinaArmeniaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBhutanBoliviaBosnia & HerzegovinaBotswanaBrazilBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCentral African RepublicChadChileChinaColombiaComorosCongoCongo Democratic RepublicCosta RicaCote d'IvoireCroatiaCubaCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEcuadorEast TimorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFijiFinlandFranceGabonGambiaGeorgiaGermanyGhanaGreeceGrenadaGuatemalaGuineaGuinea-BissauGuyanaHaitiHondurasHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJordanKazakhstanKenyaKiribatiKorea NorthKorea SouthKosovoKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMauritaniaMauritiusMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMoroccoMozambiqueMyanmar (Burma)NamibiaNauruNepalThe NetherlandsNew ZealandNicaraguaNigerNigeriaNorwayOmanPakistanPalauPalestinian State*PanamaPapua New GuineaParaguayPeruThe PhilippinesPolandPortugalQatarRomaniaRussiaRwandaSt. Kitts & NevisSt. LuciaSt. Vincent & The GrenadinesSamoaSan MarinoSao Tome & PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth SudanSpainSri LankaSudanSurinameSwazilandSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTogoTongaTrinidad & TobagoTunisiaTurkeyTurkmenistanTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited States of AmericaUruguayUzbekistanVanuatuVatican City (Holy See)VenezuelaVietnamYemenZambiaZimbabwe What is the problem that you want to solve?: (min 500 characters; max 1000 characters) Is your community already using a complementary currency? (required) yesno Desired monetary system: mutual credittime bankingloyalty programmunicipal currencycircular economy Desired government system: autocracyaristocracydirect democracy How many people do you reckon that will use the token?: Less than 100100-500501-10001001-1000010001-50000more than 50000 When would you need to release your token: Fourth quarter 2018First quarter 2019Third quarter 2019Fourth quarter 2019 Tell us some words about yourself: (min 500 characters; max 1000 characters)
