Charity Donation Request Form

Please use the form below to request approval for your Blood Drive, Platelet or Plasma Charity Donation Request

Blood Drive, Platelet or Plasma Charity Donation Request Form


This is an online form, please login or register, if you are a first-time user.

The Masonic Blood+Organ Donor Program is dedicated to the promotion of blood collection and blood products in our Masonic Lodges and appendant organizations. As Masons, we are taught compassion and concern for our fellow man. What better way do we have to demonstrate this virtue, than by offering the greatest gift – the gift of life – to our society?

In order to promote active participation in blood collection among our Masonic Lodges and appendant organizations, the Board of Directors of the Masonic Blood+Organ Donor Program has approved a charitable donation of $10 for each unit of blood collected at a Masonic affiliated blood drive, payable to a Masonic charity. Units commonly called “Double Reds” will qualify as two units collected.

In addition to regular blood drives, platelet and plasma donations also qualify for charitable donations. For individuals making platelet donations, each donor is permitted up to 24 units per year. Plasma donors are allowed 12 units per year.

The sponsoring Masonic Lodge or Masonic appendant organization must direct the charitable donation to a Masonic affiliated, IRS registered, 501 (c)(3) charitable organization. All blood drives applying for this charitable donation must be pre-approved by the Masonic Blood+Organ Donor Program, prior to the blood drive, by using a donation request form.

All Masonic-related organizations operating under the Grand Lodge of Pennsylvania are encouraged to sponsor a Masonic Blood Drive and will be eligible to submit a request for charitable donations.

It is highly recommended that blood drives executed under this program be held in Masonic Lodges or places of Masonic affiliation and significance. This is done to promote our good deeds to the communities in which we reside and to showcase our Lodges. While this is recommended, it is also recognized that not all Masonic buildings have the necessary amenities to host a blood drive (temperature control, lighting, location of restroom facilities, physical access for people and equipment, etc.). It is permissible to hold a blood drive at a non-Masonic facility if you have received prior approval and you truly endeavor to promote the blood drive as a Masonic Blood Drive.

Below is the CHARITY DONATION REQUEST AND PAYMENT FORM. Please follow the directions below, paying particular attention to the procedure, the timelines and necessary information to accompany the form.

1. This form is comprised of two portions: the drive/donor information and the donation addendum to be completed after the drive. Please fill out the first portion of the form, including all donor or drive information requested, and submit the form. All submissions MUST be received a minimum of 30 days before the blood drive for approval. You will receive an email when your drive is approved.

2. Conduct your blood drive. When the drive is completed, ask the blood collection agency to give you a verification form listing the number of units collected and signed by the person in charge from the agency.

3. Once your drive has been completed, please visit your active drives page, edit your drive and mark the drive as completed on the form. When the drive is marked as complete, a section titled “Charity Payments” will appear at the bottom of the form. Please fill out all applicable fields in that section, attach the verification form from the collection agency and submit the form for review. (PLEASE NOTE: List ONLY the number of units collected – NOT THE NUMBER OF DONORS WHO CAME TO THE DRIVE.) To receive payment, all completed forms must be received no later than 45 days after the blood drive. Your donation will be sent directly to your designated charity, unless otherwise requested. The charity is always requested to inform the sponsoring Lodge or appendant organization of their receipt of the donation.

For questions about completing this form or receiving payment, please contact Brother Larry J. Bilotto (

A new REQUEST FORM is required for every new blood drive.

Amend: 1.4.2022

To use this form please login or register. Alternatively, you can download the drive forms below.

Prefer to use PDFs? Please use the links below.