Swarthmore College COVID-19 Vaccination Verification Form for Vendors/Subcontractors/Volunteers
Vendors/Subcontractors/Volunteers ("vendors") — An individual who is hired by the College or otherwise rendering some service to help the College carry out its day-to-day operations and, to do so, needs to enter campus buildings, must be fully vaccinated. Vendors cannot be exempt from the College COVID-19 vaccination requirement.

Please fill out this form indication that you are fully vaccinated.
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Email *
First Name *
Last Name *
Mobile Phone Number *
Name of company/organization (if applicable). *
If not applicable, please enter N/A
Primary phone number for company/organization (if applicable). *
If not applicable, please enter N/A
Name and Email of Primary Point of Contact at Swarthmore College *
Briefly Describe Your Work With the College *
I verify that I am fully vaccinated against COVID-19 *
You are fully vaccinated two weeks after receiving the second dose of the Pfizer or Moderna COVID-19 vaccine, or the single dose of the Johnson & Johnson vaccine.
A copy of your responses will be emailed to the address you provided.
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