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Blood Donors Sign Up Sheet
Next Blood Drive: February 8th 2023 from 8:30 am - 2:30 pm @the Cafeteria
**PLEASE MAKE SURE TO LOOK OUT FOR OUR TEXT OR EMAIL TO CONFIRM YOUR
APPT
Review the student's guide to blood donation
HERE
for info on what to expect, getting ready for donation, etc. Remember to drink lots of water a few days before the drive and eat a good breakfast and lunch on the day of!
email Montgomeryblooddrives@gmail.com if you have any questions
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* Indicates required question
Name (First and Last)
*
Your answer
Email
*
Your answer
Cellphone Number
*
Your answer
Age
ALL DONORS NEED A PARENTAL CONSENT FORM Parental consent form
HERE
. Spanish version
HERE.
*
15 and Under
16
17 or 18
Sex Assigned at Birth
*Important to determine height and weight eligibility*
*
Male
Female
Height (ft.) and Weight (lbs.)
*important to determine eligibility*
*
Your answer
Sports Athlete? If yes, is your sport in season?
if you're an athlete and your sport is in season, please check with your coach that you're able to donate to avoid interference with games and practices (No strenuous exercise for 24 hours after donation)
*
Your answer
Most to least preferred period to donate (include subject, teacher, room #)
ex: period 2, ap gov, coach fischbein, 201
period 1, biology, mr. smith, IT7
period 3, ap lit, mrs. brinkman, 304
*
Your answer
Blood type
this will help us determine if you're eligible for a whole blood or
power red donation
*
I don't know
A+
A-
B+
B-
O+
O-
Have you donated in the past?
reminder: you must wait at least 56 days between each whole blood donation and 112 days between power red donations
*
Yes
No
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