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2021/22 COVID Rapid Testing Kits - Request Form
This form is being previewed. All form submissions will be ignored.
Business Name
*
Contact Name
First Name
*
Last Name
*
Contact Phone Number
*
Contact Email Address
*
To download the Government of Alberta terms and conditions, please copy and paste this link into your browser: https://files.constantcontact.com/46a16d18101/f75969bb-6fc1-4567-b546-774946a936c9.pdf
Terms and Conditions
*
I have read the terms and conditions below, and would like to take advantage of this program. Please send me an "Alberta Rapid Screening Tests Application"
An “Alberta Rapid Screening Tests Application” is required and a signed copy must be returned to the Airdrie Chamber to agree to the Terms and Conditions, prior to your order being placed. Once your business enters into the agreement, a member of the Chamber team will contact your business within 3 working days to complete the remainder of the forms. We will inform you when your tests are ready for pick up at the Chamber office. You will be responsible for the program at your workplace from there on. Your organization is responsible for providing reports EVERY MONDAY to the Chamber. Failure to do so, and your business will be ineligible to receive additional kits. You will be contact
Number of Tests Requested
*
25 test (1 Box)
50 tests (2 Boxes)
75 tests (3 Boxes)
100 tests (4 Boxes)
Tests are only provided in multiples of 25.