Update your Information | Sanlam Nigeria

Customer Contact Update Form

Kindly input your email address in the form below to update our record.

<p><section class="sds-life-calculator reclamation contact-update-record">     <div class="sds-life-calculator__wrapper">         <form action="/api/updateContactRecord" id="contact-update-record-form" method="POST" role="form">             <input type="hidden" name="lang" class="form-control" value="en">             <input type="hidden" name="http_referer" class="form-control" value="self-service/update-your-information">             <div class="sds-life-calculator-screen-1">                 <small>Fields marked with an <font color="red">*</font> are required</small>                 <div class="sds-life-calculator-screen-1__field-container">                     <div class="sds-life-calculator-screen-1__field-column-one">                         <div class="sds-life-calculator-screen-1__field-row">                             <div class="sd-textfield__container sd-textfield__container--full-width">                                 <label class="sd-textfield__label" for="mobile">                                     Mobile Number <font color="red">*</font>                                 </label>                                 <input required type="text" name="MOBILE" class="sd-textfield" minlength="13">                                 <br><small class="error assistive-error">e.g. +2348034037755</small>                             </div>                         </div>                     </div>                 </div>                 <div class="sds-life-calculator-screen-1__field-container">                     <div class="sds-life-calculator-screen-1__field-column-one">                         <div class="sds-life-calculator-screen-1__field-row">                             <div class="sd-textfield__container sd-textfield__container--full-width">                                 <label class="sd-textfield__label" for="first_name">                                     First Name <font color="red">*</font>                                 </label>                                 <input required type="text" name="FIRST_NAME" class="sd-textfield">                             </div>                         </div>                     </div>                 </div>                 <div class="sds-life-calculator-screen-1__field-container">                     <div class="sds-life-calculator-screen-1__field-column-one">                         <div class="sds-life-calculator-screen-1__field-row">                             <div class="sd-textfield__container sd-textfield__container--full-width">                                 <label class="sd-textfield__label" for="last_name">                                     Last Name <font color="red">*</font>                                 </label>                                 <input required type="text" name="LAST_NAME" class="sd-textfield">                             </div>                         </div>                     </div>                 </div>                 <div class="sds-life-calculator-screen-1__field-container">                     <div class="sds-life-calculator-screen-1__field-column-one">                         <div class="sds-life-calculator-screen-1__field-row">                             <div class="sd-textfield__container sd-textfield__container--full-width">                                 <label class="sd-textfield__label" for="email">                                     Email Address <font color="red">*</font>                                 </label>                                 <input required type="email" name="EMAIL" class="sd-textfield">                             </div>                         </div>                     </div>                 </div>                 <div class="sds-life-calculator-screen-1__field-container">                     <div class="sds-life-calculator-screen-1__field-column-one">                         <div class="sds-life-calculator-screen-1__field-row">                             <div class="sd-textfield__container sd-textfield__container--full-width">                                 <label class="sd-textfield__label" for="residential-address">                                     Residential Address                                 </label>                                 <input type="text" name="residential-address" class="sd-textfield">                             </div>                         </div>                     </div>                 </div>                 <div class="sds-life-calculator-screen-1__field-container">                     <div class="sds-life-calculator-screen-1__field-column-one">                         <div class="sds-life-calculator-screen-1__field-row">                             <div class="sd-textfield__container sd-textfield__container--full-width">                                 <label class="sd-textfield__label" for="social-media-handle">                                     Social Media Handle                                 </label>                                 <input type="text" name="social-media-handle" class="sd-textfield">                             </div>                         </div>                     </div>                 </div>                 <div class="sds-life-calculator-screen-1__field-container">                     <div class="sds-life-calculator-screen-1__field-column-one">                         <div class="sds-life-calculator-screen-1__field-row">                             <div class="sd-textfield__container sd-textfield__container--full-width">                                 <label class="sd-textfield__label" for="night-time-phone-number">                                     Night-time phone number                                 </label>                                 <input type="text" name="night-time-phone-number" class="sd-textfield">                             </div>                         </div>                     </div>                 </div>                                                                                          <div class="sds-life-calculator-screen-1__button-row">                     <button type="submit" class="sd-button sds-life-calculator-screen-1__quote-button">                         <span class="sd-button__container">Submit</span>                     </button>                 </div>             </div>     </div>     </div>     </form>     </div> </section></p>

Fields marked with an * are required

Mobile Number *
e.g. +2348034037755

First Name *

Last Name *

Email Address *

Residential Address

Social Media Handle

Night-time phone number

Customer Contact Update Form

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