FORSYTH COUNTY DOCUMENT UPLOAD MCV4 VACCINE
PLEASE FILL OUT ALL FIELDS ON THIS FORM AND SELECT VALIDATE IN ORDER TO UPLOAD YOUR DOCUMENTS:

Student Last Name:    Date of Birth:  

School:  [Select One] Alliance Academy Denmark High School East Forsyth High School Forsyth Central High School Lambert High School North Forsyth High School South Forsyth High School West Forsyth High School

Confirmation Email Address: 

I agree that I am legally authorized to submit this information as the legal parent or guardian of the impacted student. I further agree, under penalty of law and per the Electronic Signature Act, that I am the person who is signing my name inside the electronic signature box and understand this electronic signature is considered equivalent to a signed or faxed signature.

- I Agree      Type Full Name: