Tell Us You're Vaccinated Form

To get more students vaccinated, Northland is extending its participation in the White House and the U.S. Department of Education's COVID-19 College Vaccine Challenge.
  • For all students who receive their first or second vaccine between October 6th-November 12th, you will receive $100 cash (disbursed to your student account starting November 15th)
  • When you receive your second dose during this time frame, your name will be entered into a drawing for $500 cash on November 15th (two drawings for each campus).
Complete the "Tell Us You're Vaccinated" form. Then, upload a photo of your vaccination card.

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* 1. Contact Information

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* 2. Upload a photo of your vaccination card

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