Philadelphia Building Trades Council COVID-19 Vaccine Interest Form
The purpose of this form is to gather information from individuals affiliated with a construction trade union about their interest in receiving the COVID-19 Vaccination within Philadelphia County. Completion of this form is voluntary. The information entered on this form will only be used for purposes of connecting you with where you can register to receive the COVID-19 vaccine and will be used by the Philadelphia Building Trades to to assist members in obtaining the vaccine. Completion of this form does not guarantee that you will receive the vaccine and does not preclude you from obtaining the vaccine from your local pharmacy or doctor's office. This form should only be completed by individuals who are members of a trade union.
Cement Masons and Plasters Union Local 592
Electricians Local 98
Elevator Constructors Local 5
IATSE Local 8
International Union of Painters and Allied Trades District Council 21
Ironworkers Local 401
Insulators and Allied Workers Local 14
Laborers Local 57
Laborers Local 332
Operating Engineers International Union of Local 542
Plumbers Local 690
Reinforced Iron Workers Riggers and Machinery Movers Local Union 405
Roofers and Waterproofers Local 30
Sheet Metal Workers Local #19
Sprinklerfitters Local 692
Steamfitters Local 420
Teamsters Local 107
Bricklayers and Allied Crafts Local 1
Eastern Atlantic States Regional Council of Carpenters
Boilermakers Local 13
I am not a member of a union
Are you an active or inactive member of your union?
Do you want to receive a COVID-19 vaccine?
I'm not sure yet
I already received my COVID-19 vaccine.
Have you completed the City of Philadelphia's Vaccine Interest Form? This form is being managed by the City of Philadelphia's Department of Health and is available here: https://covid-vaccine-interest.phila.gov/
I'm not sure
The Philadelphia Building Trades are working with the City of Philadelphia's Department of Health to identify specific opportunities for trades members to obtain their vaccine, but you may also wish to complete the City of Philadelphia's Resident Vaccine Interest Form. This optional form is available to everyone and may be shared with your friends and family: https://covid-vaccine-interest.phila.gov/
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