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Sim Type*
- Standard Sim
- Micro SIM
- Nano SIM
Title
First Name*
Last Name
Email*
Alternative Contact Number
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Street*
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Where did you hear about us?
Country you call the most
- We would like to send you tailored offers and exclusive discounts each month courtesy of Lycamobile. Please, tick this box if you would prefer not to receive these emailsirst Choice
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1. The truncated card number is
2. If any changes in the consent agreement will be notified by SMS/Email
3. This agreement will last for 365 days.
4. You can delete your payment card details at any time you choose via your own online ‘MyAccount’
5. In order to adhere to certain bundle purchase Terms & Conditions you may need to have a valid payment card on file in order to maintain payments
6. Stored card details can be used for
- a. Auto Renewals/bundle subscriptions
- b. Auto top ups
7. Please find the cancellation and refund policies below
- https://www.lycamobile.pt/en/termscondition/
- https://www.lycamobile.pt/en/help/lycamobile-privacy-policy/

Bundle Name/Topup	Amount	EXPIRY_DATE_OF_AGREEMENT	FEE_AMOUNT	TAX_AMOUNT	TOTAL_PURCHASE_AMOUNT	Transaction Frequencey