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Vaccination Waitlist
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Name (First and Last):
*
Your answer
Stetson ID Number (800#):
*
Your answer
Phone Number (mobile):
*
Your answer
Email:
*
Your answer
What date will you be leaving DeLand? If you are staying all summer or live locally, please type "local".
*
Your answer
Where will you be going when you leave DeLand? If not applicable please type "N/A."
*
Your answer
Are you still interested in a vaccine at Stetson after you leave DeLand? If not applicable please select "N/A."
*
Yes
No
Unsure
N/A
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