Yes Study

Please fill in a valid value for all required fields

Please ensure all values are in a proper format.

Are you sure you want to leave this form and resume later?

Are you sure you want to leave this form and resume later? If so, please enter a password below to securely save your form.

You must upload one of the following file types for the selected field:

There was an error displaying the form. Please copy and paste the embed code again.

There was an error initializing the payment processor on this form. Please contact the form owner to correct this issue.

Which country are you applying from?

Branch

Agency

Name (As Per Passport) *

First Name

Last Name

Email*

Confirm Email *

Whatsapp phone number*

Current residential address in India

Address Line 1

City

State/Province

ZIP / Postal

Reconfirm PIN code

Address in Canada*

Address Line 1

City

Province

Postal Code

Which province will you be residing in?*

Alberta, Manitoba, Ontario, Prince Edward Island, Quebec, Saskatchewan British Columbia, New Brunswick, Newfoundland and Labrador, Nova Scotia

Date of birth*

Are you 18+ years of age?*

Yes No

Are you 19+ years of age?*

Yes No

Please contact customersupport@canadiansim.com for an alternate prepaid solution.

Purpose of travel? *

Study Work PR Tourism

College or university name*

Postpaid plan *

Rogers 5G - $50 + Tax - 120GB Data + Unlimited Canada & USA Calling + USA Roaming & Unlimited International Texts + 1,000 International Long Distance minutes from Canada to INDIA, Bangladesh, China (including Hong Kong), Mexico & UK. Rogers 5G - $40 + Tax - 100GB Data + Unlimited Canada-wide Calling & Unlimited International Texts + 1,000 International Long Distance minutes from Canada to INDIA, Bangladesh, China (including Hong Kong), Mexico and UK. Fido - $35 + Tax - 75GB (LIMITED TIME OFFER) Data + Unlimited Canada-wide Calling & Unlimited International Texts + 1,000 International Long Distance minutes from Canada to INDIA, Bangladesh, China (including Hong Kong), Mexico and UK.

Do you have a confirmed travel date to Canada?*

Yes No

Arrival date into Canada*

Tentative arrival date into Canada*

Flight Number

Brand of your current phone*

Model (Example XR, Note 3, 8 Pro, etc.)

Do you have a SIM card?*

Yes No - Ship to my address above No - ESIM Requested - I Have An ESIM Compatible Phone No - Pick up from Toronto Pearson International Airport Terminal 1 No - Pick up from Toronto Pearson International Airport Terminal 3 No - Pick up from Calgary International Airport No - Pick up from Edmonton International Airport No - Pick up from Halifax International Airport No - Pick up from Winnipeg International Airport

Shipping

My shipping address is the same as my Indian address above I have a different shipping address

Shipping address

Address Line 1

City

State/Province

ZIP / Postal

Reconfirm pin code

ZIP / Postal

Landmark

20-Digit SIM card number (Starts with 8930)*

Confirm *

Work permit number/PR card number/Canadian entry visa number

Passport number*

Upload the picture page of your passport

No File Chosen

File uploads may not work on some mobile devices.

Acceptable Formats: jpg, jpeg, gif, png, bmp, tif, pdf.

Upload a picture of the last page of your passport

No File Chosen

File uploads may not work on some mobile devices.

Acceptable Formats: jpg, jpeg, gif, png, bmp, tif, pdf.

Have you received your Canadian entry visa/ETA/permit?*

Yes No

Note: In order to process your SIM card application, a valid Canadian entry visa is required.

Our CanadianSIM support team will be connecting with you to obtain your Canadian entry visa information. Alternatively, you can connect with our team directly, via phone or email, to update your Canadian entry visa once received.

Canadian entry visa number visa/ETA/permit*

Canadian entry visa/permit issue date

Canadian entry visa/ETA/permit expiry date*

Upload a picture of your Canadian entry visa*

No File Chosen

File uploads may not work on some mobile devices.

Acceptable Formats: jpg, jpeg, gif, png, bmp, tif, pdf.

Interested in new phone?*

Yes No

Interested in home internet?*

Yes No

Acknowledgement and Understanding

By checking this Box*

I acknowledge and understand that this is a postpaid plan.

By Checking This Box*

I acknowledge and understand that I will receive monthly bills from Rogers/Fido.

By Checking This Box*

I acknowledge and understand that it is my responsibility to make the monthly bill payments on time.

By Checking This Box*

I acknowledge and understand that I am solely responsible for the financial obligations of paying my Rogers/Fido bill in Canada.

Signature*

[clear]

Use your mouse or finger to draw your signature above