In-Person Attestation Form | North Carolina Advocates for Justice

In-Person Attestation Form

Name

Name

First

First

Last

Last

Email

Bar Number

Company/Firm/Agency Name

Name of NCAJ Event/Date

Please check one:

I attest that I have received the COVID-19 vaccination.

Upon arrival at the registration desk, I will provide a negative COVID-19 test that has been taken within 72 hours of attending NCAJ meeting/event.

Signature

By checking this box, I am electronically signing this form.

Date