Volunteer Application

Join us as we work together to support Vitalant's mission of saving lives through blood donation.

Start your volunteer journey by filling out the form below:

Profile Information

First Name

Last Name

Date of Birth

Contact Information

Country

Address

Apt/Ste

City

State

Zip Code

County

Phone Number

* One phone number is required.

Emergency Contact

First Name

Last Name

Phone Number

* One phone number is required.

Create Your Account

Passwords shall be a minimum of eight (8) characters in length and be comprised of three of the following four groups of characters Uppercase letters, lowercase letters, numerals, and special characters. Special characters cannot be used as the first character for your password.

Username

Password