Blood Drive Sign Up Nov 15, 16th
Student Council Member
Donor Name (First and Last)
Donor Age (If 16, you MUST have a parent consent form. Parent consent forms available in F128)
Blood Drive Height and Weight Requirements
Do you fit the Height and Weight Requirements?
Which period would you like to donate?
First Period Teacher (if late start put 2nd period teacher with an asterisk ex: Becker*)
Do you fit the requirements for a Power Red Donation? (Check all that apply) If you don't fit all the requirements then you cannot do Power Red
Blood Types of O negative, O positive, A or B negative
at least 130 lbs.
Would you like to make a Power Red Donation?
Donor Cell Phone Number
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