Appointment Registration (open to all communites)
Event Day: Sunday, April 25
Time: 11:00a.m.-5:00p.m
Event Address: Berwyn Senior Center (26155 Richardson St.) Dearborn Heights, 48127
Contact us at: or (313) 791-3490
First Name *
Last Name *
Phone Number *
Zip Code *
Are you 18 or older? (Moderna vaccine is only approved for those 18 and older) *
Select Your Time on Sunday, April 25: *
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy