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2021 COVID-19 Vaccine Awareness Week in Construction - Certificate of Participation

To receive a certificate of participation, please complete the entire form. If you have any questions, please contact Nazia Shah at nazia.shah@agc.org or (703) 837-5409.
1.Company Information(Required.)
2.Which AGC chapter(s) do you belong to?(Required.)
3.Contact Information (person completing form)(Required.)
4.When and where (city, state) did your event take place? You can input multiple dates and locations.(Required.)
5.Explain the details of your event below. If you had different events at different locations, list the location and then describe the event.(Required.)
6.How many of your employees participated in vaccine awareness week, across your company and jobsites?(Required.)
7.Information for certificate(Required.)
8.Do you have photos form your event that you would be willing to share with us?(Required.)
9.Is there any additional information you would like to provide?