• 1. Card order form

  • 1. Card order form

  • 1.2 Shipping Address

  • 1.3 Address change

  • 2 - Contribution amount details

  • How much did you contribute on Pre-sale from Aug 4 - Sep 4?
  • ETH BTC LTC
    Wallet Address
    Currency
  • 3. Total number of Tokens received directly from Centra

  • On Pre-sale (Aug 4 - Sep 4)
  • On ICO White list (Sep 5 - Sep 16)
  • On Public ICO (Sep 19 - Oct 5)
  • 4. Change of Ethereum address

  • 5. Card order

  • Please specify how many of each cards you are ordering

    You cannot order more than 1 blue card per contribution.

  • Amount of Titanium Cards

  • Amount of Black Card

  • Amount of Gold Metal Cards

  • Amount of Gold Cards

  • Amount of Blue Cards

  • Bellow 5 ETH only gets APP Access Code

  • 6. Additional Notes

  • Please leave any information you think the Developers/Core Team should know about your order in the box below.