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All DAISI volunteers must complete this questionnaire and supply documented evidence of a negative COVID swab test results taken within seven days of their departure for the South Pacific.

    Given Name (as it appears on your passport) *

    Last Name (as it appears on your passport) *

    Telephone (Mobile)*

    Email Address *

    Have you or any of your household been in close contact with a COVID positive case in the past one month?

    Have you displayed any symptoms of COVID in the past week including:
    • Cough
    • Fever
    • Runny nose
    • Sore Throat
    • Headache
    • Malaise
    • Altered taste or sense of smell

    Do you have a recent negative COVID test result less than 7 days from your scheduled departure for the South Pacific?

    Do you confirm your answers to be truthful being aware that Under the Customs Act 1901 there are severe penalties for making a false or misleading statement? *

    [recaptcha]