Expression of Interest for purchase of Rapid Antigen Testing (RAT) kits

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* 1. Please provide your contact details:

Name

Position

Service Name

Postcode

E-mail

Mobile

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* 2. How many RAT kits are you interested in purchasing over the next 4 week period? Please note that orders must be placed in lots of 100, with a minimum order of 100 kits for Members and 200 kits for Non-Members.

Week 1: 31 January - 6 February 2022

Week 2: 7 - 13 February 2022

Week 3: 14 - 20 February 2022

Week 4: 21 - 27 February 2022

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* 3. Are you a member of the Australian Childcare Alliance (ACA) NSW?

Yes

No

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* 4. ACA NSW Membership Number