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Certificate of Immunization Card Upload

 

Required

Must contain a date in M/D/YYYY format
My child will be entering:Please select one.
Please select one.
Student Namerequired
First Name
Middle (optional)
Last Name
Parent or Guardian Namerequired
First Name
Middle (optional)
Last Name
Must contain only letters
Must contain only numbers
A Certificate of Immunization is required for each child. Please upload your Certificate of  Immunization below.
Attach up to 2 files with a maximum size of 10MB
No file chosen