InfoTek Perspective Services:

SMS Short code Service Request Form

The client is required to complete and return this form with respect to the assignment and activation of
the requested SMS Shortcode across all networks, for the operation of its premium SMS service in
Nigeria. Upon the reception of the completed form, InfoTek will submit to the client a Service
Specification Form which will include the commercial terms for the provision of the shortcode.
Reg Form: InfoTek Date:

Information related to the Client

Company name:
Address :
Web site :
Name of the Project Manager:
Title : Tel : Email :

Specification of the offered Service

Type of service : Mobile Marketing & CRM Mobile Banking

Mobile Infotainment / Voting/ Entertainment Other
Name and Describe How The Shortcode Will Be Used:

.
.
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SMS Shortcode Service Spcification

Type of shortcode requested: Dedicated Shared

List of keywords (if applicable) :

Premium rate tariff* (incl. VAT) :

* Available premium rated end-users tariffs are: N10, N30, N50, N100 (per SMS)
* List of mobile operators with direct SMPP connection: Globacom, MTN, Airtel, Etisalat
Inbound traffic forecast Average Number of SMS-MO Per Month:
Application platform is hosted & managed by
Mode of connection to the SMS Gateway SMPP Email
2x1-way HTTP X or 2x1-way HTTPS
Database & Type ....................................

Expected launch date:.......... Live Duration :

Customer Care contact: Tel Website Url: ..
Email: .

Make payment into: GTBank, InfoTek Perspective Services, 000 393 8903