COVID-19 Vaccination Card Upload Form

Covid-19 Negative Test Form

As of January 1, 2022, AVA Gallery and Art Center requires all staff, instructors, volunteers, and participants (ages 12 and up) in our programs to either show proof of vaccination against Covid-19, or provide a negative PCR Covid-19 test (taken within 72 hours of a scheduled class session or event).

If you are uploading a negative Covid-19 test, please do so below.

If you would prefer to provide a negative Covid-19 test in person or via email, please stop by our office during normal business hours (T-F, 11 am-5 pm), or email info@avagallery.org.

Click here to upload proof of Covid-19 vaccination.

AVA takes the privacy of our participants, employees, and teachers extremely seriously. This is a HIPAA compliant form, and we will not share information provided here with any third parties.

For further info about AVA's Covid-19 policies, please click here, or email AVA's Executive Director Shari Boraz (shari@avagallery.org) or Education Manager Nick Gaffney (nick@avagallery.org).

Name *

First Name Last Name

Email *

example@example.com

Phone Number *

Please enter a valid phone number.

Upload a Photo or Scan of your negative Covid-19 test. The test must have been administered within 72 hours prior to attending a class session or event at AVA. *

Today's Date *

Date