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January 15th Blood Drive Appointments
Please fill out the info below! The blood drive is on January 15th. Thank you for doing your part and saving lives!
The blood drive will be on January 15th
11 AM - 5 PM
Memorial Hall
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First name
*
Your answer
Last name
*
Your answer
Phone Number
*
Your answer
Appointment Time (11 am - 5 pm)
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11-11:30
11:30-12
12-1:30
1:30-2
2-2:30
2:30-3
3-3:30
3:30-4
4-5
Are you donating double red? *Double Red allows you to safely donate two units of red blood cells during one donation while returning your plasma and platelets to you. Double Red is blood type specific and for donors who are larger in stature and heavier in weight.*
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Yes
No
Blood Type (Optional)
Your answer
Did anyone recruit you? List name if so
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