Blood Drive Interest Survey

Every day, blood donors help patients of all ages: accident and burn victims, heart surgery and organ transplant patients, and those battling cancer. In fact, every two seconds, someone in the U.S. needs blood.

Clark County REMC would like to partner with the American Red Cross to host a blood drive in order to help our community members in need. Unfortunately, we cannot set a date for the drive without first generating a solid interest. 

Please fill out the short survey below.

Did you know by donating one pint of blood (your body has 10-12!), you can save up to 3 lives! 

Those interested in participating in the blood drive will be contacted once a date and time is set. 

Thank you!

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* 1. What is your first and last name?

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* 2. What is the best phone number to reach you at?

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* 3. What is the best email address to reach you at so that we can send you information?

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* 4. Are you interested in donating blood at the Clark County REMC office in October?

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* 5. Once a date is set may we contact you to schedule your appoinment?

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