PARENTAL NOTIFICATION OF STUDENT BLOOD DRIVE On Tuesday, April 17, 2012, St.

Lukes Hospital will be at Clements for a blood drive. Your student has expressed a desire to participate in this Blood Drive. According to a Bill passed in the Legislature, individuals 17 years of age no longer need parental permission to donate blood. Chapter 162. Blood Banks and Donation of Blood Section 162.015 Donation of blood by persons younger than 18 years of age: A person who is 17 years of age may consent to the donation of the person's blood or blood components. A person younger than 18 years of age may not receive any compensation from a Blood Bank for a donation of the person's blood or blood components. (Acted by Acts 1993, 73rd Leg., Ch 160. Eff. Sept. 1, 1993.) However, we at Clements High School, feel it is important to communicate to the parents their student's intention to donate blood. Therefore, please fill out and sign the notification below and have your student return this to the clinic at Clements High School so that they may be scheduled for this blood drive. I give my permission for _________________________________ to donate blood at the CHS Blood Drive. ________________________________________ Parental or Legal Representative's Signature ____________ Date

Period available_____ Teacher__________________________ Room #_____________