Bitcoin Breakdown Subscriber Survey Form

Email*

1.What is your sex:

Male

Female

2.What is your age range?

Under 18

18 - 24

25 - 39

40 - 59

60+

3.What is your annual income level?

Less than $20K

$20K - $50K

$50K - $75K

$75K - $100K

$100K - $150K

$150K+

4.What is your location? (Either closest city, country or continent)

5.What industry do you work in?

6.What is your job function? (E.g., management, sales, research, marketing, etc.)

7.What is your job level / seniority? (E.g., CEO, senior management, mid-level management, specialist, entry-level, retired, intern, student, etc.)

8.Lastly, would you be interested in having access to coupon codes that afford you discounts on Bitcoin products and services?

True

False