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Giving Out the Vaccine
January 27, 2023
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Submit a COVID-19 Vaccine Location
Please note, this form is only to submit a community vaccine event that we can add to the calendar. To register for an event, you will need to sign up directly through an event’s link on the calendar.
Vaccine Calendar Submission
Date
*
Start Time
1
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9
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12
:
00
15
30
45
AM
PM
End Time
1
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:
00
15
30
45
AM
PM
Location Name
*
Address
*
Address
Address
Address
City
City
State/Province
State/Province
Zip/Postal
Zip/Postal
Phone
*
Vaccine Offered
*
Pfizer
Moderna
Johnson & Johnson
Link to Signup
Any Additional Details
File Upload
Drop a file here or click to upload
Choose File
Maximum upload size: 52.43MB
Email
*
By Clicking "Agree" below, I confirm that the information I am submitting is accurate.
*
Agree
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