Apply to the VaxDesign Donors Program

Are you in good health?:

Have you donated blood before?:

Have you donated platelets of plasma?:

Are you eligible to work in the United States?:

How did you hear about this program?: NewspaperFlyerWord-of-MouthOther

I have read and understand the information about the study, its risks, and compensation.

I understand that this study is voluntary and I do not have to take part in the study.

If I start a study, I may stop at any time, without reason.

I understand that my part in the research may stop at any time for any reason.

I understand that I may be asked to stop the study even if I do not want to stop.

I have read and acknowledged the above conditions. *