<center><img src="http://www.wam.umd.edu/~uqureshi/ARCCCP/images/membership.jpg" alt="membership.jpg" /></center>
Thank you for your interest in volunteering at our blood drives! This form will be used to forward your details to the blood drive coordinator in the event we need to reach you, and/or if you are using this opportunity for volunteer/service credit for another organization. All details collected on this form will only be used during the specific drive, this information will be deleted from our records after you are finished volunteering.
Please be aware that volunteering also entails certain obligations to professionalism and manner on the premises. You are expected to report to the blood drive coordinator on-duty and carry your duties as requested during the term of your shift. This includes but is not limited to duties such as donor recruitment, refreshment dispensing, and collecting or returning signs. If you fail to keep up with the obligations you will be suspended from future drive opportunities at the discretion of the on-duty blood drive coordinator.
Note: At no time during your shift are you allowed to breach donor confidentiality or dispense any medical advice unless trained to do so.
Your Full Name
*
Your Email Address
*
Cell Phone
Reason for Volunteering (Optional)
Would you like us to keep this information on-file for future volunteer events?
*
Yes
No
Please list the specific dates you would like to volunteer and the shift times you are available for (at least 1 hour in length between 11am-5pm)
Ex. Thursday (8/5/2010) - 11am-1pm and 2pm-3pm
Image Verification
Please enter the text from the image
:
[
Refresh Image
] [
What's This?
]
Powered by
EMF
Form Builder
Report Abuse