Register as a donor Name* Prefix Mr.Mrs.MissMs.Dr.Prof.Rev. Forename Surname Previous Surname (if applicable)Date of Birth* Gender*FemaleMaleYour current address*Please enter N/A if not applicable. Address line Address line Town/City County Postcode Location preferenceBy default you will be invited to donate at a session near your home address. If you would like a different location please specify (optional)Have you previously enrolled/donated blood?*Yes, I have enrolled/donated beforeNo, I have never enrolled/donated beforeDid you previously enrolled/donated with Northern Ireland Blood Transfusion Service?YesNo, it was another Blood Transfusion ServiceWhere you registered with the same address as above?YesNo, it was a previous address. (If known)A previous address. (Although I don't remember which one)Please note we may contact you by phone/email to confirm any address details.* Yes I understand Your previous address*Please enter N/A if not applicable. Address line Address line Town/City County Postcode Email* Enter Email Confirm Email Mobile Number*We require your mobile number so we can contact you at short notice, if needed.Landline NumberPlease note: it is our policy not to share any information you provide to us with any third parties.CommentsThis field is for validation purposes and should be left unchanged.