Thank you for filling out this COVID 19 vaccine interest survey. To indicate your interest in having your student vaccinated, please check each of the following boxes:

* I understand that the Pfizer-BioNTech COVID-19 Vaccine is a two-dose vaccination requiring a second dose 21 days after the initial vaccination. Depending on when the first vaccine is administered, the second dose would occur during the months of June or July.
* I understand the clinic for the first dose would be held during the school day.
* I understand the vaccine would be administered on the San Joaquin County Office of Education campus at 2707 Transworld Dr. in Stockton.
* I understand that transportation would not provided.
* I understand that parental consent would be required.
* Based on the information provided above, if a vaccination clinic for 16-18 year old students is offered: