UWC Vaccination Booking Management

IMPORTANT NOTICE

Please note that once your booking is confirmed and you attend the vaccination, you will have to accept the terms before you can receive the vaccination shot. Please allow for 3 days to process your request.

First Name*

Surname*

Confirm EVDS Registration*

Have you registered on EVDS and have you received an SMS to confirm Registration. If you have not registered on EVDS yet, please use the link below to register before continuing with this submission: https://vaccine.enroll.health.gov.za/#/

Yes

No

eMail Address*

ID Number*

Age (Current)*

Cellphone Number*

Eg: 0821234567 (please do not use spacing in the number)

Staff / Student / Family Member / Alumni*

Are you a student, staff member or a family member of a staff member/student/alumni?

Student

Staff Member

Family Member

Alumni

Staff / Student Number*

If you are a family member please provide the UWC staff / student number of your family member.

Vaccination Type*

Standard Vaccination

Pfizer Booster Shot

Immunocompromised Booster Shot

J&J Booster Shot

Vaccination Booking date*

Please allow for at least 3 days for bookings to be confirmed.

Vaccination Timeslot: 09:00 - 14:00

In signing up for the vaccination you consent to receive the Covid-19 vaccination that will be administered by a registered health professional at UWC.

Please confirm your consent!*

Send me a copy of my responses