Registration - Blood Donor Clinic

Amya Canada

Monday November 30, 2020
Blood Donation Registration
Last Name (*)
Please enter your last name.
First Name (*)
Please enter your first name.
Date of Birth (*)
Please enter your birthday required by Canadian Blood Services
Email (*)
Please enter a valid email address.
Postal Code (*)
Please enter your valid postal code.
Appointment Time (*)
We need everyone to book an appointment. Please select the time that works for you and we will await your arrival at that time.
Confirmation Code (*) Confirmation Code
Please enter confirmation code.
Yes I will Donate and Help Save Lives. (*)
Please confirm your commitment.