Military Order of The Cootie – Blood Donation Reports

The Supreme Vampire is requesting that ALL donating Cooties report their own individual donations online. ( if anyone doesn’t have internet access, they should call their Seam Squirrel, CCDB, or Grand Commander to have them file the report in their name.

If you have any questions or comments about this policy, please send a private message to The Supreme Vampire using the form at the bottom of this page.

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The American Red Cross Blood Donation Eligibility Requirements (click HERE )

All donation types are counted as one unit, including Whole Blood, Power Red, Platelet, and Plasma.

Individual Cootie on-line Blood Donation Form.

July 1st. 2021 thru June 30th. 2022

( you will receive a copy of this form for your records )

Donating Cooties Full Name: (required field)

Donating Cootie Number: (required field)

Cooties Email: (required field)

Cooties Phone Number: (required field)

Date of Donation: mm/dd/yyyy (required field)

Individual Units donated this visit. Whole Blood, Plasms, or Platelets all count as one unit. For individual blood donations enter 1.
If you are reporting for a Cootie sponsored Blood drive, enter that blood drives total units donated here.
Units Donated: (required field)

Lifetime Units Donated: (if known)

Your Pup Tent #: (optional)

Select your Grand: (required)

Address 1: (required)

Address 2: (optional)

City: (required)

State & Zip: (required)

Please prove you are human by selecting the Star.

Submit

To send a private message to the Supreme Vampire

use the form below.

You will receive a copy of this form in your email for your records.

Name:

Email:

Subject:

Your message:

Please prove you are human by selecting the Cup.

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