Proof of COVID-19 Vaccination for College Reps


This form will be used to verify that college representative  visitors are fully vaccinated prior to coming on Urban School's campus. The proof of vaccination will be viewed by the school's Pandemic Coordinator or Leslie Schaffer, College Counseling Associate. All copies of vaccination proof will be deleted and the only information that will be stored are the names of those who are fully vaccinated and allowed to come on campus.
Your Namerequired
First Name
Last Name
Attach up to 1 file at a time. File size may not exceed 20MB
No file chosen
The file will be deleted after review and your name will be added to a list of approved visitors.