Shaler Area HS Student COVID Vaccine Clinic
Shaler Area School District, in partnership with Giant Eagle Pharmacy, will be hosting a COVID-19 vaccination clinic for students attending Shaler Area High School.

The Pfizer COVID-19 Vaccine will be offered on Thursday, May 6, 2021 during the school day. Our Cohort C students are invited to participate from 2:45 p.m. - 3:45 p.m. This is a 2-dose series and the second dose is given 21-42 days after the first dose.

The second dose will be offered at school on June 3, 2021 during the school day. Our Cohort C students are invited to participate from 2:45 p.m. - 3:45 p.m.

Parents/guardians of current Shaler Area High School students who wish to have their child vaccinated, must:

1. Complete the registration form below by Noon on Tuesday, May 4, 2021 AND
2. Complete and bring to the clinic the immunization administration record form in its entirety, checking the
consent box, and initialing. The form can be found at: https://www.sasd.k12.pa.us/Downloads/COVID-19-Vaccine-Administration-Form-for-School-Clinics.pdf.

This immunization administration form, student's insurance card and a photo ID (driver's license or school issued ID) must be brought to the clinic on May 6, 2021.
Parent/Guardian Email Address *
Student First Name *
Student Last Name *
Student Date of Birth *
MM
/
DD
/
YYYY
Student Grade *
Current Instructional Model *
Required
Are you currently enrolled in an AW Beattie Career Center program? *
Required
Parent/Guardian First Name *
Parent/Guardian Last Name *
Parent/Guardian Cell Phone Number *
Please list a phone number that we may contact during the clinic if questions arise.
Parent Consent *
Required
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