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Editing previous response:
For School Year 2025-26
Please complete the form below. Required fields marked with an asterisk .*
Please clearly list the dates each for vaccine given. All requirements must be met for student to attend school ( This form must be accompanied with corresponding vaccination evidence in English).
Polio (Four Doses Required):
DTap / Tdap - Diptheria, Tetanus, Pertussis( Four Doses Required for ages up through 11 years of age. Five doses required for ages 12 and up). **(Ages 12 and up)
MMR - Measles, Mumbs, Rubella ( Two Doses Required)
Hepatitus B ( Three Doses)
Varicella - Chicken Pox (One Dose Required) *If student had disease, the vaccine is not required, but must be verified by medical doctor.
Second Varicella required if student is 14 years or over.