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Vaccine Registration for Hazlet Residents Aged 65+

  1. Vaccine Registration Form (1)

  2. Priority Registration Form

    Hazlet Township is teaming up with local health care systems to offer COVID-19 vaccinations for Hazlet Township residents who are aged 65 and older. Please sign up to be contacted.

  3. REGISTRATION

  4. Next, Type In Your Date of Birth

    For example: 30 08 1940

  5. Please do not include sensitive information.

  6. Submit this form. Thank you!

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