Intake form

Help us serve you better

Name *

Email address *

What services are you interested in?

Please select at least one option.

Time Banking

Nebra Coin

Virtual Neighborhoods

Community Trust Mechanisms

Task Management & Exchange

The Nebra Lottery

What is your primary goal with nebra?

How did you hear about us?

What is your preferred method of contact?

What is your location?

Additional questions or comments

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