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NDCL Blood Drive Registration Form
Please complete the information below to register as a donor in NDCL's Red Cross Blood Drive on Wednesday,
February 19th (Blue Day)
.
First name
*
Last name
*
Grade level:
*
10
11
12
Faculty/Staff
Birthdate:
Enter as mm/dd/yyyy
*
If you were born
AFTER February 19, 2004
, you are not eligible to donate at this time. We look forward to your participation in the first blood drive after your 16th birthday.
If you are 16 years old, you need to have your parents sign the required
Red Cross
permission form
.
This form must be submitted to the school office by
Monday, February 17
. Please note that this form is NOT required for students who are 17 years old or older.
Click
here
to read A Student's Guide to Blood Donation.
The Red Cross would like
ALL DONORS
to register with them as well, please click
here
to be taken over to their site to register.
If you enter your email address below, you will receive a confirmation of your appointment.
Email address
Re-enter your email address:
Cell phone number:
Enter numbers only; for example, 4402866226
Please select your preferred donation appointment time from the list below.
If your preferred appointment time is already filled, you will see an error message and will have the opportunity to select another time.
.
*
8:00 AM
8:15 AM
8:30 AM
8:45 AM
9:00 AM
9:15 AM
9:30 AM
9:45 AM
10:00 AM
10:15 AM
10:30 AM
10:45 AM
11:00 AM
11:15 AM
11:30 AM
11:45 AM
12:00 PM
12:15 PM
12:30 PM
12:45 PM
1:00 PM