On St. Patrick's Day, March 17, 2017, HOSA will be hosting the Spring Blood Drive at the UCHS GYM. Come donate blood to 3 lives!
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First Name *
Last Name *
Student ID *
Homeroom *
Grade *
Age *
Free Period or Gym Period *
Gender *
Height (Pick one closes to your actual height) *
Weight *
Email Address *
Cell Phone Number *
Have you traveled outside of the USA? *
If you left the USA, where did you go? *
Are you a senior for the Class of 2017? *
Did you donate at the Fall Blood Drive, last year in November 2016 ? *
Have you received a parent consent form? *
PARENT CONSENT (Pick one up from Eagle Nest or Print)
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