Cohort 7 COVID-19 Residential Form All Cohort 7 Scholars must complete this form by May 2, 2022. C7 – Residential – COVID Vax Status Scholar First & Last Name * Email * Are you interested in living on campus for Summer Academy? The alternative would be in-person day programming. There is no virtual option for Summer Academy 2022. * Yes No Are you fully-vaccinated against COVID-19 (1 shot of J&J or 2 shots of Moderna or Pfizer)? * Yes No Do you believe you are eligible for an exemption? (Exemptions to mandatory vaccination are based on certain medical contraindications or on sincerely-held religious beliefs, practices, or observances.) No Yes – for medical reasons Yes – for religious reasons Please upload a photo of your vaccination card here. * Drop a file here or click to upload Choose File Maximum file size: 51.2MB Do you plan to get vaccinated so that you can live on campus for Summer Academy? (The deadline to have your second dose of Moderna/Pfizer or first dose of J&J to live on campus is May 23rd.) * Yes No You must be vaccinated to live on campus this summer. The deadline to have your second dose of Moderna/Pfizer or first dose of J&J to live on campus is May 23rd. If you are not currently vaccinated but become fully vaccinated by the deadline, please email a photo of your vaccination card to collegeprep@wustl.edu immediately. If we do not receive proof of your vaccination by the following day, May 24th, you will not be allowed to live on campus. If you stated that you qualify for an exemption, the College Prep Program Leadership Team will follow up with you by email. Response to this email and completion of additional steps will be required. If not living on campus, you will be expected to take part in day programming instead. * I understand. reCAPTCHA Submit Δ