Marketing and A2P Intake Form

Marketing and A2P Intake Form
Legal Business Name*
DBA: Business Name*
Business Registration ID Type*
Business Registration Number*
This is your 9 digit EIN/Tax ID Number as issued by the Federal Government with no dash.
Business Type*
Website*
Does your current website contain a Privacy Policy/Terms and Conditions at the footer of the website?*

YesNo
Does your current website contain a checkbox to receive promotional offers like the picture provided?*

YesNo

Authorized Representative Details
Name*

First NameLast Name
Email - Please use a domain email (info@businessname.com), if you have one. If you do not have one (@gmail, @yahoo), you will need an additional step to verify your email/identity.*
info@example.com
Business Phone Number (With country code)*
Please enter a valid phone number.
Cell Phone Number*
Please enter a valid phone number.
Job Position*
ATTENTION

Advertising Campaign Duration Policy
All advertising campaigns initiated through Empowered Aesthetic Solutions must remain active for a minimum of forty-five (45) consecutive days from the launch date.

This minimum duration is essential not only for collecting reliable performance data, but also to fully optimize campaigns and achieve the best possible results. Early suspension, modification, or cancellation of any campaign before the 45-day period is strictly prohibited, as doing so may compromise both the integrity of performance analytics and overall campaign effectiveness.

Acknowledgment & Agreement

By signing below, I confirm that I have read, understood, and agreed to the terms outlined in this agreement. I acknowledge my responsibility to:
- Maintain any advertising campaigns initiated by Empowered Aesthetic Solutions in an active state for a minimum of forty-five (45) consecutive days to ensure proper optimization and the best possible results.
Signature*

Clear

Business Information