COVID-19 Vaccination Registration
Student or Employee Number
Please enter a valid phone number.
Legal State of Residence
I am 18 years or older?
I will be participating in the vaccination clinic.
I choose not to participate in the vaccination clinic.
I'm already vaccinated or receiving it elsewhere.
I choose not to participate in the vaccination clinic because: (Choose all that apply)
Do not have enough information to make an informed decision
Prefer not to disclose
Vaccinations will be given in Le Fer OSC April 7th - 9th.
Should be Empty: