7/10/22  Sign up for Free Covid-19 Vaccination
Date: Sunday, July 10, 2022
Time: 2:00pm-5:00pm
Place:  Little Asia Market at Arbeiter Brewing, 3038 Minnehaha Ave, Minneapolis, MN 55406

 Pfizer Vaccine for 6 months and up
-$25 gift cards for 6 months and up registered for either 1st dose, 2nd dose, or booster shots

All doses will be available, 1st dose, 2nd dose, and booster doses, including the 2nd booster dose if you qualify
Vaccine eligibility will be determined by a medical professional on site


Contact info@amamedia.org with questions
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Email *
First Name *
Last Name *
Email *
Age Range *
Signed parental consent is required before anyone under the age of 18 will be vaccinated (at the time of vaccination)
Gender *
Ethnicity (Response examples: Cambodian, Chinese, Filipino, Hmong, Thai, Indian, Japanese, Karenni, Korean, Laotian Native Hawaiian, Thai, Vietnamese, Multicultural, etc.) * *
Street Address *
City *
State *
Zipcode *
Phone number *
Which vaccinations will you be getting? *
Please note that you CANNOT get Booster vaccinations if you have NOT reached your 6 month mark. Even if you are 1-2 days within the date we are UNABLE to give you the dose. 16 year olds and below can ONLY get Pfizer
Required
Has your family experienced severe impact with COVID-19? *
What is your family size? (Response example: 2, 3,4, etc.) *
Do you need interpreter support?
Please put Yes if you need interpreter support and what language
A copy of your responses will be emailed to the address you provided.
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