Subscriber Application Form – New Connection
Order a new SIM
SIM Replacement/Upgrade
For Upgrade, Lost, Faulty & Damaged
1
Personal information
2
Identification details
3
Delivery details
4
Confirm & submit
First name
Name as per NIC
Last name
Name as per NIC
078/072 Number
078
Alternate number
NIC Number
E-mail
Delivery address
Reason for Replacement/Upgrade
Select
Upgrade to 4G
Lost SIM
Damaged SIM
Faulty SIM
Identification Details
Select Number Preference
078 SIM
072 SIM
Select ID Type
NIC
Passport
NIC Number
Upload NIC Image
Upload NIC Image
Upload passport/license Image
*Allowed Image format PNG, JPEG
*Max Upload Size is 5MB
Terms & Conditions
I accept the terms & conditions
Proceed to step 2
Personal Details
First name
Name as per NIC
Last name
Name as per NIC
Contact number
Required to obtain Delivery time and date
Email
Required for order confirmation
Convenient calling time
Select
8.30 am - 9.30 am
1.00 pm - 2.00 pm
6.00 pm - 9.00 pm
Required to schedule appointment for delivery
Convenient Delivery day
Select
Weekdays
Weekends
Required to schedule appointment for delivery
Go back to step 1
Proceed to step 3
Delivery Details
Permenant address
Delivery location
Select location
Gampaha
Kandy
Colombo
Kalutara
Kurunegala
Kegalle
Matara
Galle
Ampara
Anuradhapura
Badulla
Batticaloa
Hambantota
Jaffna
Kilinochchi
Mannar
Matale
Moneragala
Mullaitivu
Puttalam
NuwaraEliya
Polonnaruwa
Ratnapura
Trincomalee
Vavuniya
Nuwara%20Eliya
Select this box if the Delivery address is same
Delivery location
Go back to step 2
Proceed to step 4
Confirm & Submit