The Knights of Columbus Kent Council 8150, in collaboration with the Puget Sound Blood Center

Invite you to donate blood on Monday, November 17, 2008

Between the hours of 1:00 pm - 3:00 pm, and 4:00 pm - 7:00 pm

 

 

This form will allow you to electronically register your appointment request to the coordinator who

will respond to you with a confirmation of availability based on the time(s) you request.  Each time block

has limited space available, so please select multiple times that you can accommodate.

 

Please select the time(s) you would prefer for your appointment:      

1:00 PM    1:15 PM    1:30 PM    1:45 PM

2:00 PM    2:15 PM    2:30 PM    2:45 PM

4:00 PM    4:15 PM    4:30 PM    4:45 PM   

5:00 PM    5:15 PM    5:30 PM    5:45 PM

6:00 PM    6:15 PM    6:30 PM    6:45 PM

7:00 PM

 

Fields in red are required

Name :             

Phone:  

EMail:    

 

If we need to contact you by phone, please indicate the best time to call:       Before noon       Early afternoon        Evening

 

When you have completed the form, click on the submit button to send your information request.

IMPORTANT!  After submitting, please wait for the confirmation message to verify completion of your registration.