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) *
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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.
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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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