December 12th Blood Drive Sign - Up
Sign up to donate at the upcoming blood drive below!
Email address *
Before anything, check the weight chart!
Do you weigh enough? *
How old are you? *
What is your date of birth? *
MM
/
DD
/
YYYY
What grade are you in? *
Do you have any tattoos? *
Student Number *
Last Name *
First Name *
Phone Number *
Period you'd like to come in *
Make sure to grab a permission slip from the College and Career Center or in front of the library. Or, you can have it emailed! *
How did you hear about the blood drive? *
If you heard from a friend, or you chose "other", who referred you?
I will bring my signed permission slip on December 12th! *
Thank you for choosing to donate, it's for a worthy cause!
Join the Blood Drive Remind @blddrv2020 for future updates!
A copy of your responses will be emailed to the address you provided.
Submit
Never submit passwords through Google Forms.
reCAPTCHA
This form was created inside of Clark County School District. Report Abuse