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COVID-19 Vaccination Status Submission

Please complete the form below. Required fields marked with an asterisk *

If you have multiple scholars attending that are vaccinated against COVID-19,

you should submit one form per scholar.

This form is for 2021-2022 Proof of COVID-19 Vaccination. Please do not submit this form until your scholar is fully vaccinated against COVID-19. If your scholar has not been vaccinated, there is no need to complete this form.
Contact [email protected] if you have any questions regarding the form.

Scholar First Name*

Answer Required

Scholar Last Name*

Answer Required

Guardian Name*

Answer Required

Guardian Contact Number*

Answer Required

Guardian Email Address *

Answer Required

Please attach proof of COVID-19 vaccination here.*

Answer Required

Choose a file or drag it here.

Confirmation Email

Confirmation Email *

Email Required