DC 37 Vaccination Appointment Request
Please complete this form and we will call you directly to schedule your appointment.
First Name *
Last Name *
Are you a member of District Council 37? *
At this time we are only able to schedule apppointments for active DC 37 members. We cannot schedule appointments for family members nor DC 37 retirees.
Which Local are you a member of? If you don't know your Local, please call Membership Records (212) 815-1570 and they will provide it to you. *
Which agency do you work for? *
What is your job title? *
What number would you like us to call you at to schedule your appointment? *
We will only use this number to contact you regarding scheduling your appointment.
What is your e-mail address? *
Please do NOT use your work email address, doing so could be a violation of your workplace regulations.
What is your preferred language? *
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