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NJBIA Staff Vaccination Questionnaire

Following federal and state guidance, NJBIA is requesting all staff certify that they have or have not been fully vaccinated against COVID 19 before working in the office unmasked and not being required to keep a 6 foot distance from co-workers.   This information will be received and maintained by the Chief Operating Officer/CFO only, will be kept fully confidential and not used for any personnel decisions.  If your vaccination status changes, please resubmit this form.

NJBIA reserves the right to change this policy at any time.

Staff Questionnaire

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  • This field is for validation purposes and should be left unchanged.

Download a PDF version of this form