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ECI Vaccine Incentive VISA Card Drawing
All drawings will be held on Monday, November 15, 2021 & winners will be contacted by November 16, 2021.
Drawing 1 - $100 VISA card - fully vaccinated by 8/31/21 - 20 winners
Drawing 2 - $100 VISA card - not vaccinated as of 8/31/21 & gets fully vaccinated by 10/31/21 - 3 winners
Drawing 3 - $200 VISA card - fully vaccinated by 7/31/21 - 5 winners
To qualify you must be an ECI participant and fully vaccinated by the date indicated for that drawing.
*Are you an ECI participant (working with a Coordinator)?
YES
NO
Select option
*Name of IL Coordinator working with
Type name of IL Coordinator
*Name
Type your name
*Street Address
Type your street address
*City
Type the city you live in
*State
Type the State you live in
*Zip Code
Type your zip code
*Phone Number
Type in home/cell phone number
*Email address
Enter your email address
Vaccination Verification Information
You will need to provide information from your Vaccination Record Card to be eligible for these drawings. Information is secure.
*Date of last vaccination shot
Type date of last shot
*Vaccine Type
Choose a Vaccine Type
Pfizer-BioNTech
Moderna
Johnson & Johnson
Vaccine Lot #
Type lot # from Vaccine Card
Information provided on this site is for the intended purpose and will not be shared.
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