COVID-19 Vaccine Request (Students 12+)

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New Bedford Public Schools students and members of their families, age 12 or older, will have the opportunity to receive the 𝗣𝗳𝗶𝘇𝗲𝗿 COVID-19 vaccine at New Bedford High School from 4:00- 6:00pm on Tuesday, June 15 and from 10:00am- 12:00pm on Wednesday, June 16. Currently this vaccine is only approved for individuals 12 and older. We are assessing who would be interested in receiving the vaccination. Parents, please complete all fields of this form indicating your interest.

Note: filling out this form does not signify an obligation to your choice, one way or the other.

If your child is age 12 or over, would you like them to receive a COVID-19 vaccination? *

Yes, I would like my child to receive the COVID-19 vaccine.

No, I would not like my child to receive the COVID-19 vaccine.

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