Holocaust Survivors and Senior Registration for Priority COVID-19 Vaccinations -
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First name - (legal) *
Last name *
Address *
Will you require transportation for the appointment? (Boro Park residents only) *
Phone number *
Date of birth - month/day/year *
Email address
Primary contact- family or caretaker *
Phone number of primary contact *
What is the name of your primary social service agency? *
Visit https://www.bpjcc.org/donate to make a donation and have a part in the BPJCC's many vital events and services.
Comments or questions
Thank you, we will reach out to you for scheduling shortly. For transportation in Boro Park only, please call the BPJCC after you have scheduled your appointment - (718) 972-6600 ext. 4602.
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