Oh, i can take your info here, actually.
Please provide:

Pseudonym: __________

Instance: ____________

Date of Birth: _________

Desired Frequency:
- [ ] Twice-monthly
- [ ] Monthly
- [ ] Bi-monthly
- [ ] Hexa-monthly

Probe-Style Preference:
- [ ] Synthetic
- [ ] Biological

Filling and sending the form will constitute consent for further contact

---

::: spoiler Privacy Policy
We will put your information in an unsecured Firebase storage bucket for the 'Channers to access :::