Wade S. Walden FDD Platelets Heroes Award Honor Roll Submission Form

Knights of Columbus Washington State Council

Wade S. Walden FDD Platelets Heroes Award Honor Roll Submission Form
Grand Knight *

First Name Last Name
Grand Knight's Email *
example@example.com
Council # *
District # *
The following members of my council or their family members have donated a total of fifty (50) or more platelets of blood. In the "STATUS" column. please indicate, member, spouse. son. or daughter. If necessary, submit additional forms. *
Please verify that you are human *
Should be Empty:

Knights of Columbus Washington State Council