First and Last Name

Email Address

Phone Number

Street Address

State

City

Country

Zipcode

Campaign Use Case Campaign Use CaseAlertsChatDonationEducationEmergency AlertsFraud AlertsPoliticalPromotional MarketingSocialSweepstakes/ContestTwo Factor AuthVoting/PollingOther

Campaign Description (Max Length: 100)

Business Name

Tax ID of Business (Format: xx-xxxxxxx)

Marketing Display Name

Business URL

Industry IndustryAgricultureConstructionEducationEnergy/UtilitiesEntertainmentFinancial ServicesGamblingHealthcareHospitalityInformation Technology ServicesInsuranceManufactoringMass Media/CommunicationNon ProfitPublic SectorReal EstateRetailOther

Please provide a sample of a SMS message you plan to send. (Max Length: 100)

Do you provide a way for the subscriber to opt-in? Do you provide a way for the subscriber to opt-in? Yes No

How does the subscriber opt-in? How does the subscriber opt-in?WebsiteKeywordVerbalIVR

Website URL for subscriber opt-in?

Keyword for subscriber opt-in?

Do you provide a way for the subscriber to opt-out? Do you provide a way for the subscriber to opt-out? Yes No

Do you provide a way for the subscriber to receive support after they reply with HELP? Do you provide a way for the subscriber to receive support after they reply with HELP? Yes No

Does your campaign utilize pool of phone numbers? Does your campaign utilize pool of phone numbers? Yes No

Are you using an embedded link of any kind? Are you using an embedded link of any kind? Yes No

Will this campaign include content related to direct lending or other loan arrangements? Will this campaign include content related to direct lending or other loan arrangements? Yes No

Is affiliate marketing being use or was used in the construction of this campaign? Is affiliate marketing being use or was used in the construction of this campaign? Yes No

Will this campaign include any age-gated contact as defined by carrier and CTIA guidelines? Will this campaign include any age-gated contact as defined by carrier and CTIA guidelines? Yes No