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MYOC Vaccination Registration
Event Timing: Sunday, May 2, 2021,9:00am - 4:30pm
Event Address: To Be Determined
Contact us at (714) 583-0123 or
myoc.contact@gmail.com
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Date of Birth/Raan in Lotak
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First Name
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Last Name
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Sex/Kadkadūm
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Prefer not to say/Ij jab maroñ uak ilo torain
Email
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Telephone Number
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Street Address/Namba im etan ialin jikin eo kwoj jokwe ie
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City/Bukōn
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State/Lal
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Zip/Namba an bukōn eo kwoj bed ie
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Do you currently work?/Ewōr ke jerbal kwoj bed ie ilo torain?
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No/Jaab
I do not wish to answer at this time/Ijjab maroñ uak ilo torain
If you answered "yes" to the above question, what is your occupancy/Job title/Elañe uakin kajitok eo mokta lok ej "aet", jerbal rot ne kwoj bed ie ilo torain?
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