Registration Form

UPCOMING VACCINATION EVENTS IN DISTRICT 5 DEKALB COUNTY

Which Vaccination event will you be receiving your gift card at? *

Voter Registration + Vaccination Event ( April 1st) (Location: DeKalb Voter Registration and Election Office
New Bethel Church ( April 3rd)d Choice
Big Miller Grove Missionary Baptist Church (April 9th)
Transforming Faith Church (April 16th)

How many dependents will be receiving their vaccination/ booster shot?

Which Vaccination will you be receiving? *

Covid-19 Vaccination (how many in your family)
Covid-19 Booster shot (how many in your family)

What is the best contact number?

What is your email address? *

Confirm Email

Your registration is complete we will see you on [ date chosen] and [location chosen]. Please check your email for a calendar invite for your convenience. Please follow our social media to know current events in DeKalb County.

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1300 Commerce Drive

Registration Form

Upcoming Vaccination Events in District 5 Dekalb County

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