GixelyCoin Signature campaign Reg form

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GixelyCoin Signature campaign Reg form

All participant must signup for Gixely Wallet to receive their bounties.

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* Indicates required question

BitcoinTalk username *

Your answer

BitcoinTalk Profile Link *

Your answer

Bitcointalk User Rank *

Junior Member

Member

Full Member

Senior Member

Hero Member

Legendary Member

GixelyCoin Avatar ? *

Yes

No

Gixely Wallet Address *

Your answer

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