Student Vaccine Passport Form

Student Vaccine Passport Form

Please only complete this form if you are a registered student.
Full Name *
Student ID Number *
E-mail Address *
Will you be attending classes on campus in Winter 2022? *

On Campus Online Co-op Placement
College Institution *

ILAC Canadian Tourism College Sterling College
Vaccine Administration Status *

Fully Vaccinated Partially Vaccinated Not Vaccinated
Please upload your vaccine dose administration receipt below. If you are fully vaccinated, please upload your 2nd dose receipt only.

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Please take a photo of yourself for your vaccine passport. No sunglasses, no hat and no face mask on. *
If you were previously only Partially Vaccinated; Are you resubmitting the form to update your vaccine status to Fully Vaccinated? *

Yes No
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