Form Center

By signing in or creating an account, some fields will auto-populate with your information and your submitted forms will be saved and accessible to you.

Board & Commission Member Vaccination Pin: A Badge of Honor

  1. Blue lapel pin with the words, "COVID-19 Vaccinated" and The Little City logo
  2. You got the COVID-19 vaccine! Congratulations and thank you! You're doing your part to help us get back to normal.

    Please complete the form below and the City of Falls Church Office of Communications will send you a pin that you can wear on your lapel, badge lanyard, or stick in a corkboard! Display it with pride.

    Sorry, our quantities are limited, so we can provide only one pin per member of the primary City boards and commissions.

  3. Leave This Blank:

  4. This field is not part of the form submission.