The answers to the questions...

What is the name of the coin?
StartCOIN

What is the coin's symbol?
START

Please link to the announcement page.
https://bitcointalk.org/index.php?topic=651307.2480

If the coin has a website, please link it here.
https://www.startcoin.com/

If the coin has a block explorer, please link it here.
http://explorer.startcoin.org/

Thanks John, we should really focus and make it happen.

Are you sure the form is working properly? Always get a blank screen after submitting the form!

Thats what I got so sent an email explaining to contact@poloniex.com with the details