Immunization form - Anoka Ramsey Community College - anokaramsey 2026

1. Click ‘Get Form’ to open it in the editor.
2. Begin by entering your Student Name (Last, First, M.I.) clearly in the designated field.
3. Fill in your Date of Birth and Student ID Number accurately to ensure proper identification.
4. Indicate your Date of Enrollment (Mo/Yr) to confirm your admission status.
5. If you were born before 1957, check the exemption box; otherwise, proceed to complete Parts 1, 2, 3, and/or 4 as applicable.
6. For Part 1, if you graduated from a Minnesota high school in 1997 or later, sign and provide the name of your high school and graduation date.
7. In Part 2, if you are a transfer student from another Minnesota college, sign and include the name of that college along with your enrollment dates.
8. Complete Part 3 by providing vaccination dates for Td and MMR if applicable. Ensure accuracy when certifying this information with your signature.
9. For Part 4, indicate any medical or conscientious exemptions by checking the appropriate boxes and providing necessary details. Sign where required.

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