Wormhole Request Form
Please ensure that you are accurate with your request, as we won't bother you with systems that are not at least close to what you have submitted. So if you would be happy with one of several different systems, feel free to submit several requests.
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Desired Class *
Desired Primary Static *
Desired Secondary Static *
Desired System Effect *
Desired System Width *
Desired Static Type *
Desired Moon Quantity *
Contact Name *
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