By submitting this information, I hereby declare that:

•  I do not have COVID-19 symptoms such as cough, sore throat, shortness of breath or headache
•  I have not had close contact with a confirmed COVID-19 case in the past 14 days
•  I am not currently under a Quarantine Order
•  I confirm that the information provided is complete and accurate
•  I have read and understood the Personal Data Protection Notice by Great Eastern and hereby give my consent to Great Eastern to collect, retain, process and disclose my personal data to any relevant authorities or bodies as compelled by Law.