COVID-19 Vaccine Interest Form

Brothers and Sisters,

As the COVID-19 vaccine continues to roll out into our communities, we know how important it is to ensure our members are getting the information and care they need. All District Council 21 members who are interested in receiving the vaccine within Philadelphia County can fill out the following form, put together by the Philadelphia Building Trades: https://form.jotform.com/210406051625140

This form is completely voluntary and is only for use by trade union members. The information you provide on this form is confidential and will only be used by the Philadelphia Building Trades to connect you with where you can register to receive the COVID-19 vaccine. Completion of this form does not guarantee that you will receive the vaccine and does not preclude you from obtaining the vaccine from your local pharmacy. Continue to stay safe, on and off the job site, and don’t hesitate to reach out to the union hall with any concerns.

Sincerely,
the FTI of the Mid-Atlantic Region

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