Business Info Form - Twilio Registration Info

After completing the initial Twilio account set up actions (card on file & invite us as a user), please fill out this form with your business info and we will complete the Twilio account set up and registration with carriers. By submitting this form you agree that your Leadngage Trial is over once our team starts working on your Twilio. In the future, your only required task in Twilio is to keep your card on file updated. For more information on Twilio Fees & Leadngage Overage Charges visit www.leadngage.com/twiliofees

First Name *

Last Name *

Company Email *

Area Code Preferences (For Twilio Marketing Number)

Website *

Business Country *

United States

Canada

United States Minor Outlying Islands

Other

Business Legal Name *

Employer Identification Number (US: EIN, CAN: BN) *

Business Type *

Registered Business Address: *

Caller ID: Name to display on outgoing calls *

I agree to Leadngage registering and managing my company profile on Twilio. Once form is submitted, your Leadngage trial ends when our company starts your Twilio registration. By checking this box, you agree the initial charges you will pay to Twilio include $4 brand regisration and $15 campaign fee as well as $1.15/mo for the phone line and $1.50/mo for the campaign once approved plus any additional usage, taxes, and fees as assessed by Twilio. These costs are in addition to the Leadngage platform fees.

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