Blood Donation Camp Registration

Blood Donation Camp Registration

Organization Name:

Organizer Name:

Organizer Mobile No:

Organizer Email Id:

Co-Organizer Name:

Co-Organizer Mobile:

Camp Name:

Camp Address:

State:

City Name:

Camp Propose Date:

Start Time (24HH:MM):

End Time (24HH:MM):

Latitude:

Longitude:

Estimated Participants:

Reference/Camp Supporter(Prayojak):

Remarks: