MORAGA SCHOOL DISTRICT Volunteer COVID-19 Vaccination Status Form

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All volunteers in Moraga School District must attest to vaccination status.

Last Name *

First Name *

Moraga School - Please mark all that apply. *

Camino Pablo

Donald Rheem

Los Perales

Joaquin Moraga

District Office

Required

Current COVID-19 Vaccination Status

Please mark your current vaccination status below.

I am fully vaccinated for COVID-19.

I am in the process of being fully vaccinated for COVID-19. I understand that I will not be able to volunteer on campus.

I am not vaccinated for COVID-19. I understand that I will not be permitted to volunteer on campus.

I prefer not to state my vaccination status. I understand that I will not be permitted to volunteer on campus.

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