Mount Zion Missionary Baptist Church
Secure Online Form

VACCINATION SIGN UP

 

First Name:  

Last Name:  

eMail:  

 

How many people in your party:  

 

Preferred Date(s):

  June 18th, 4-6p

  July 9th, 4-6p

 

Which vaccination (click all that apply):

  Pfizer-BioNTech (1st shot)

  Pfizer-BioNTech (2nd shot)

  Johnson & Johnson