100 Radon Test Kit Campaign

100 Radon Test Kit Campaign

Community Liaison Sign up Form
Name

First Name Last Name
Email
example@example.com
Phone Number

Area Code Phone Number
Address

City/Town Province

Postal
As a Community Liaison; are you with a:

non-Profit Organization Municipal Office non-Corporate Entity
Community Recruitment Plan
Please share with us how you will recruit community members. (You can type below or upload a document detailing your recruitment plan.
Community Recruitment Plan (you can upload if you prefer)

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Test Kit Distribution and Collection Strategy
Please share with us how you will distribute and collect the radon test kits from your community participants. (You can type below or upload a document detailing your Distribution and Collection Strategy)
Test Kit Distrubtion and Collection Strategy (if you prefer to upload it)

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Additional Information:
Is there any additional information that you would like from us as your are developing your campaign
Should be Empty: