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Employer-Sponsored Blood Drives Grant Funding Opportunity: Application, F-03042 (05/2022)

Introduction

The information provided on this form serves as an application for the Employer Sponsored Blood Donation Program created in accordance with 2021 Wisconsin Act 58, Section 9119.

To complete the Employer Sponsored Blood Donation Program grant application, fill in all required information and submit this online application.

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  • The required questions are highlighted by an asterisk (*) and must be answered to receive grant funds.
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Employer Contact Information
1. Person completing this application *This question is required.
2. Employer Information *This question is required.
This question requires a valid number format.
3. Authorized Representative/Signatory (Person signing the grant agreement) *This question is required.
Application
This question requires a valid number format.
5. Where are the physical location(s) in Wisconsin your blood donations will occur? *This question is required.
6. When did you or do you anticipate hosting your blood donation opportunity? *This question is required.
This question requires a valid date format of MM/DD/YYYY.
calendar
7. Which nonprofit blood bank are you working with to sponsor your blood donation opportunity? *This question is required.