Empire State Volunteer Corps Donate Life Month T-Shirt Request Form

By supporting Donate Life New York State’s Donate Life Month campaign this April, you have the power to save lives. Our goal is to raise awareness about organ, eye, and tissue donation and inspire New Yorkers to enroll in the Donate Life Registry. To receive your complimentary t-shirt, please complete the form below by Tuesday, March 18. Limit one t-shirt per student.

ESVC Donate Life Month T-Shirt Request Form

Name(Required)

Email Address(Required)

Phone(Required)

Shipping Address(Required)

Street Address Address Line 2 City State ZIP Code

T-Shirt Size Requested(Required)

Phone

This field is for validation purposes and should be left unchanged.