California Indian Manpower Consortium, Inc Vaccine Incentive Program

Application Guidelines

Application and eligibility documents must be received end of the event on December 29, 2022. Complete applications will be considered on a first come, first served basis until funding is expended. Incomplete applications will not be processed.

• Eligible applicants may receive a $150.00 incentive payment for each COVID-19 vaccination This includes the first dose, second dose and/or booster.
• Each applicant is limited to a one-time incentive payment during this
• The maximum amount that an applicant may receive during this event is $150.00. No applicant may receive more than one incentive payment during the event.
• Applicant may not receive an incentive payment for COVID-19 vaccinations and/or boosters received prior to or after the event.
• Incomplete applications will not be Verification for Incentive Payments
• Proof of Eligibility: Applicant must provide verification that they are ONE of the following: Native American, a household member living with a Native American and/or a Tribal and/or Native organization employee.
  • Native American
    • Tribal enrollment/identification card
    • Letter on tribal stationery signed by the Tribal Chairperson or enrollment clerk
    • Birth Certificate identifying the applicant as American Indian, Alaska Native or Native Hawaiian
    • California Indian Census Roll Number
  • A household member living with a Native American
    • Any of the eligible verification of Native American heritage for at least one household member
  • Tribal and/or Native organization employee
    • Employee Identification/Badge
    • Letter from organization stationery signed by a staff member in Human Resources, Executive Director, Tribal Administrator or Tribal Chairperson
  • Valid Photo Identification: Applicant must submit a photo identification that matches the name on the proof of COVID-19 vaccination. Valid identifications may include but are not limited to:
    • Tribal Enrollment Identification
    • Driver’s License
    • State Identification
    • School Identification
    • Employee Identification/Badge
  • Proof of COVID-19 vaccination: Applicant must provide documentation that verifies the COVID-19 vaccination was received on December 29, 2022. Verification of vaccination may include but are not limited to:
    • COVID-19 Vaccination Record Card
    • Documentation of vaccination from health care provider that provided the COVID-19 vaccine
    • California Immunization Registry Vaccination Record
    • World Health Organization Vaccine Record Card

Download the Incentive Application:  Vaccine-Incentive-Application