KNIGHTS

OF COLUMBUS
IN sERvIcE To ONE. IN SERVICE TO ALL.

Suffolk Chapter Knights of Columbus

Blood Drive Donation Report
July t,2014- June 30,2015
a

Council Number and Name

Grand Knight

Blood Chairman and Phone

Date of Blood Donations

LI Blood Services Group ID

Number of Registered Donors*

Number Deferred

Automated Red Cell Donors (Alyx)

Whole Blood Donors

Total Units Donated

Did Any Donors use Your Local Blood Services Sites to Donate? (y/Q

Did they use your Group Number for that Donation? (y/n)

How Many donations of Platelets were made at the Blood Services Site?

Upon completion ofyour Blood Drive, please complete this form using the information on
the Blood Center receipt given by the LIBS on site supervisor and send to
Blood Drive Chairman, John Finn PGK, DD.
JTFDD@hotmail. com (preferred)
or via USPS to:
John Finn PGK, DD
30 Berard Boulevard
Oakdale,
11769-1709
Thank youfor being a blood donor or group leader

NY

*Number of persons who filled out

Questionnaires and presented themselves for the pre-donation exam

Revision 2/14