Complete this form for assistance from a volunteer to schedule an appointment for the COVID-19 vaccine. Please note: The specific criteria for who we are currently helping in each state is outlined below. Someone will be in touch over the phone, text, or email to get the information required to help book your appointment.
As a reminder, NO volunteer will ever ask you for your Social Security Number or Insurance details. There are no guarantees beyond the promise that our volunteers will do their best to secure you an appointment. Our volunteers will not take requests for a particular date and time or a particular vaccine brand.
Important: Please DO NOT complete this form if you are in a position to help yourself, or someone you love, secure an appointment. Thank you for honoring our mission and being thoughtful before submitting a form.
New Jersey Residents
If you are a New Jersey resident age 16+ you are welcome to apply for assistance.
Please select the county you live/work in and click "Continue" to start the form.
¿Vive en Nueva Jersey y habla español? ¡Clic aquí!
Please select the region you live/work in and click "Continue" to start the form.
We are currently assisting the following populations in New York:
- Seniors (50+)
- People with limited access to technology or the Internet.
- People with language barriers.
Support In Other Languages
¿Vive en Nueva York y habla español? ¡Clic aquí!
뉴욕에 거주하며 한국어로 도움이 필요하십니까? 여기를 클릭하세요!
न्यूयॉर्क में रहते हैं और हिंदी में मदद की ज़रूरत है? यहां दबाएं
Ou abite nan New York epi ou pale kreyòl ayisyen? Klike la a.
Живет в Нью-Йорке и нуждается в помощи на русском языке? Пожалуйста нажмите здесь.
The WGIRLS INC
Founded in 2007, by a group of young professional women in New York City, WGIRLS INC was created to meet the needs of underserved women and children in the local community. Today through fundraising and volunteer initiatives, WGIRLS Inc. creates reverberating change in thousands of lives through its continued commitment to meet the needs of women and children in local communities throughout the country.
If you would like to learn more about our work or make a donation to support our efforts we encourage you to explore the site or contact us at email@example.com.