Christians Giving the Gift of Life

Blood for the World.Org

Initial registration form

You need to register here before updating your blood donations. We must apologise that the process is not more automated but we will get there in time. Once you have submitted the form we will allocate you a membership number which you will use when you update your blood donations

Registration Form

Please will you complete the fields below with your own information and press the submit button when you are done. Please pay special attention to the Agreement Section—if you do not accept the terms of the Agreement, then unfortunately we cannot process your registration

Agreement:

· I agree that the information that I have supplied is correct and may be used by Blood for the World.Org to record blood donations against my name.

· I agree that by registering with Blood for the World.Org that I consider my blood safe for use by other people.

· I agree that I will try to donate blood at least 4 times within a calendar year.

· I agree that I will not abuse the blood donation system to check the status of my health

Office Phone:

E-mail:

First Name

Age

Gender

Church

City

Country

Surname

Middle Initials

Title

Marital Status

Home Address:

Blood Bank Org

Donor Number

Blood Group

No. of Donations

Last Donation Date

Role in Church

ID Number

Date of Birth

DD

MM

CCYY

I would like to be kept up to date with Blood for the World.Org news

Date

Time

Home Phone:

Fax Number

Copyright © 2004 Blood for the World.Org

Postal Address:

Mobile Phone: