COVID Attestation

North Hennepin Community College
Administration
coronavirus@nhcc.edu

You are not legally required to provide the requested data. If you do not show proof of full vaccination against COVID-19 and fail to participate in weekly COVID-19 testing as required by the Minnesota State Guidelines, your ability to continue living in college or university residence halls, your participation in athletics, and/or your participation in selected college or university activities may be impacted.

The Minnesota Government Data Practices Act and the Family Educational Rights and Privacy Act classifies your vaccination status as private data about you. The data collected from you may be shared with your college or university staff, your college or university’s safety administrators, members of your college or university’s staff with a business need to know, and other persons or entities authorized by law.

Indicates required field

Demographics

Legal First & Last Name

Email Address

StarID (If applicable)

Phone

Participation Information

NHCC Student or Community Member?

NHCC Student

Community Member

What Are You Participating In?

Fine Art & Music Activity

Student Life & Recreation Activity

Nursing Clinicals

Other

Where Will You Be Participating?

Vaccine Attestation

Are You Vaccinated Against COVID-19?

I am fully vaccinated against COVID-19

I am not sharing my COVID-19 vaccination status

Vaccine Documentation

By uploading a copy of my COVID-19 Vaccination card, I attest that it is valid and true.

Documentation

Your documentation file can ONLY be in PDF or JPG format. Images with the file extension HEIC (often produced by iPhones) will need to be converted to JPG format. You can convert your image here:

https://cloudconvert.com/heic-to-jpg

One file only.
10 MB limit.
Allowed types: jpg, pdf.