Submit your idea by the December 12, 2016. 
If you have a team (no more than 5 members), please elect 1 member to fill out this form. Have the rest of the names and emails handy.
First Name *

Last name *

Where in the world are you located? *

Ex: San Francisco, CA, USA
Nationality? *

Will you be hacking with a team? *

Enter the names, nationalities and emails of your team mates.

John Doe, American,
Jane Doe, Canadian,

If you're not sure yet, just say so below.
Using the scale below, rate your experience level with blockchain. *

Don't worry if you're not that experienced! This is a perfect way to learn!
Which challenge do you intend on going after? *

Tell us about your pitch or submission idea.

Submissions will be vetted before the next round. Leave blank if undecided.
Want to be invited to the Blockchain Virtual GovHack SLACK? *

This is where you can chat with other hackers. Meet potential teammates. Ask for tech support. And more!
Do you agree to the participation agreement? *

Are you interested in hearing more about Blockchain technology and UAE events in future? * *

Thank you! Keep your eyes on your inbox :)

You'll hear from us soon! Questions? email or click the button on the bottom right of the hackathon website. 
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