StaySafe Ambassador Application
Thank you for your interest in the StaySafe program! Please use this form to tell us a bit more about yourself and why you want to be a StaySafe Ambassador.
What is your name (first and last)? *
What is your email address? *
What is your phone number?
What is your age range? *
Have you previously been involved with rapid testing? *
How would you use the rapid tests you will receive as a StaySafe Ambassador? *
How will you use your position as a StaySafe Ambassador to tell others about rapid testing? *
Thank you for your application. You will receive an email with next steps within 48 hours. In the meantime, if you have any questions please reach out to
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