Lifesouth Community Blood Centers Appointment Card

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LIfESouth CommunIty BLooD CEntErS
LIfESouth CommunIty BLooD CEntErS
Appointment CArd/HAll pAss
Appointment CArd/HAll pAss
Student’s Name: __________________________________
Student’s Name: __________________________________
Teacher: _________________________________________
Teacher: _________________________________________
Blood Drive Date: _____________
Apt. Time: _______
Blood Drive Date: _____________
Apt. Time: _______
Destination: ___________________________________
Destination: ___________________________________
•Donors must be 17 or older (16 with written parental
•Donors must be 17 or older (16 with written parental
consent), weigh at least 110 lbs., and show photo I.D.
consent), weigh at least 110 lbs., and show photo I.D.
•Eat a good meal at least four hours before you donate.
•Eat a good meal at least four hours before you donate.
•Do not lose this card. It is your pass into and out of
•Do not lose this card. It is your pass into and out of
the classroom.
the classroom.
Finish Time: ____________________
Finish Time: ____________________
LifeSouth Employee Signature: ___________________________
LifeSouth Employee Signature: ___________________________
LIfESouth CommunIty BLooD CEntErS
LIfESouth CommunIty BLooD CEntErS
Appointment CArd/HAll pAss
Appointment CArd/HAll pAss
Student’s Name: __________________________________
Student’s Name: __________________________________
Teacher: _________________________________________
Teacher: _________________________________________
Blood Drive Date: _____________
Apt. Time: _______
Blood Drive Date: _____________
Apt. Time: _______
Destination: ___________________________________
Destination: ___________________________________
•Donors must be 17 or older (16 with written parental
•Donors must be 17 or older (16 with written parental
consent), weigh at least 110 lbs., and show photo I.D.
consent), weigh at least 110 lbs., and show photo I.D.
•Eat a good meal at least four hours before you donate.
•Eat a good meal at least four hours before you donate.
•Do not lose this card. It is your pass into and out of
•Do not lose this card. It is your pass into and out of
the classroom.
the classroom.
Finish Time: ____________________
Finish Time: ____________________
LifeSouth Employee Signature: ___________________________
LifeSouth Employee Signature: ___________________________

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