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Voluntary Vaccination Reporting (TBO Members Only)
IMPORTANT: Updated Temple COVID-19 protocols require self-reporting of vaccination by all members in order to participate in any in person services or events.  If you cannot self-attest to being vaccinated you will need to join us virtually. Non-members: This form is for members only. Please email your vaccine card to office@templebethor.org. Thanks
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Email *
Name of Member #1 *
Member #1 Vaccine Status *
Name of Member #2
Member #2 Vaccine Status
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Name of Member #3
Member #3 Vaccine Status
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Name of Member #4
Member #4 Vaccine Status
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Name of Member #5
Member #5 Vaccine Status
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