Midwest Music Foundation COVID-19 Self-Collection Test Kit Application

JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.

Midwest Music Foundation is providing FREE COVID-19 tests to musicians and music industry personnel without access to affordable testing.

Tests will be available on a first come, first serve basis. This clinic service is provided by Jackson County Outside Agency funding.

MMF does not endorse or make any statements on the accuracy of these tests.

Please contact rhonda@midwestmusicfound.org with any questions

Email *

FIRST NAME *

LAST NAME *

PHONE NUMBER *

ADDRESS - Street, City, State, Zip *

Please give a short description of your employment as a Musician or Music Industry Personnel. *

Is this your first time applying for this test with MMF? *

Yes

Clear form

Never submit passwords through Google Forms.

This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy

Forms