Vaccination Proof - Form - Young Israel of the West Side

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Vaccination Proof

* First Name

* Last Name

* Email

* Cell

How many proofs of vaccination will you be uploading at this time?

Please enter the names of each person for whom you are submitting proof of vaccination.

* First Name of Guest

* Last Name of Guest

* Per NYC requirement, please upload proof of vaccination for everyone in your household who will attend YIWS in person, for any reason. You may submit proof for multiple people at one time by either clicking multiple files to upload, or clicking the box below additional times to add files one at a time.

Sun, January 16 2022 14 Shevat 5782

210 West 91st Street - New York, NY 10024

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