Republic of the Philippines

Department of Education
REGION III
SCHOOLS DIVISION OF TARLAC PROVINCE
CARDONA NATIONAL HIGH SCHOOL

February, 2020

VICTOR O. SANTOS JR.

Officer in Charge
School Governance and Operations Division
DepEd, Tarlac Province
San Roque, Tarlac City

Sir:

I am writing this letter to seek your approval for the conduct of proposed community outreach
entitled, “Mobile Blood Donation Outreach Program: Safe blood saves lives and improves health.”

The Community Blood Donation Outreach program aims to perform act of kindness,
empathy and compassion to other people by giving out Safe blood donations and to aid the
community in the constant need for regular blood supply because blood can be stored for only a
limited time before use. Regular blood donations by a sufficient number of healthy people are
needed to ensure that safe blood will be available whenever and wherever it is needed. And
because Blood is the most precious gift that anyone can give to another person — the gift of life.
A decision to donate a blood can save a life, or even several if your blood is separated into its
components — red cells, platelets and plasma — which can be used individually for patients
with specific conditions.

Cardona National High School established a partnership and coordination with the
Philippine Red Cross, Tarlac Chapter in organizing a Blood Letting Activity for a period of 3
years, promoting safe and healthy blood donation drive and as well as advocating kindness,
empathy, and compassion towards the members of the community and service in aiding the
Department of Health in their hope for many individuals becoming regular voluntary unpaid
donors to guarantee sufficient supply of safe blood and to meet national blood necessities.

Your immediate response to this request is highly appreciated. Thank you and may God bless you
and your endeavors!

Respectfully yours,

RENZ DOMINIC D. GONZALES

Proponent

Noted:

ALEXANDER R. AMIGO
Principal I

Address: Cardona, Gerona Tarlac

Telephone No.: 0919-993-9873
Email Address: 300959@deped.gov.ph
 Republic of the Philippines
Department of Education
REGION III
SCHOOLS DIVISION OF TARLAC PROVINCE
CARDONA NATIONAL HIGH SCHOOL

COMMUNITY OUTREACH PROGRAM PROPOSAL

I. TITLE:

“Mobile Blood Donation Outreach Program: Safe blood saves lives and improves health.”

II. BACKGROUND/RATIONALE:

Republic Act No. 7719, also known as the National Blood Services Act of 1994,
promotes voluntary blood donation to provide sufficient supply of safe blood and to regulate
blood banks. This act aims to inculcate public awareness that blood donation is a humanitarian
act.

Cardona National High School in partnership with The Philippine Red Cross is targeting
the youth as volunteers in its blood donation program this year. In accordance with RA No.
7719, it aims to create public consciousness on the importance of blood donation in saving the
lives of millions of Filipinos.

Why donate blood? A question that is always brought in the table. The answer is very
simple; Safe blood save lives and improves health. And because blood transfusion is needed
for women with complications of pregnancy, such as ectopic pregnancies and hemorrhage
before, during or after childbirth; children with severe anemia often resulting from malaria or
malnutrition; people with severe trauma following man-made and natural disasters; and many
complex medical and surgical procedures and cancer patients.

Blood is the most precious gift that anyone can give to another person — the gift of life.
A decision to donate your blood can save a life, or even several if your blood is separated into its
components — red cells, platelets and plasma — which can be used individually for patients
with specific conditions.

There is a constant need for regular blood supply because blood can be stored for only a
limited time before use. Regular blood donations by a sufficient number of healthy people are
needed to ensure that safe blood will be available whenever and wherever it is needed.

Based from the data from the National Voluntary Blood Services Program, a total of
654,763 blood units were collected in 2009. Fifty-eight percent of which was from voluntary
blood donation and the remaining from replacement donation. This year, particular provinces
have already achieved 100% voluntary blood donation. The DOH is hoping that many
individuals will become regular voluntary unpaid donors to guarantee sufficient supply of safe
blood and to meet national blood necessities.

III. OBJECTIVES:
1. Advocate the spirit of kindness, empathy, and compassion among the members of the
community;
2. Development of a fully-voluntary blood donation system;
3. Contribute in the mission of DOH and PRC in producing individuals that are regular
voluntary unpaid donors and guarantee sufficient supply of safe blood in meeting
national blood necessities.
4. Attainment of maximum utilization of blood through rational use of blood products and
component therapy; and
5. Improvement of a sound, viable sustainable management and program for the coordinated
blood donation network.

Address: Cardona, Gerona Tarlac

Telephone No.: 0919-993-9873
Email Address: 300959@deped.gov.ph
 Republic of the Philippines
Department of Education
REGION III
SCHOOLS DIVISION OF TARLAC PROVINCE
CARDONA NATIONAL HIGH SCHOOL

IV. PROPONENT:

ALEXANDER R. AMIGO
Principal I
Cardona National High School

V. TARGET CLIENTELES:

The target clienteles of the said activity are the volunteers from the faculty and
staff of Cardona National High School, volunteer students from the Senior High School
Department of Cardona National High School, representatives from the partner LGU’s
of Cardona National High School, and representatives from the other secondary schools
in Gerona, Tarlac.

VI. SCHEDULE OF ACTIVITIES:

A. PLANNING
PERSON/S RESOURCE MEANS OF
ACTIVITIES TIME FRAME
INVOLVE REQUIREMENT VERIFICATION
Consultation with the January 2020 Proponent Notebook Notes from the
School Head (2nd Week) School input
Head
Drafting the Project January 2020 Proponents Laptop Draft of the
Proposal (3rd Week) School Bond Paper activity
Head Printer
Finalization and January 2020 Proponent Laptop Approve
submission of Project (4th Week) School Bond Paper Project
Proposal and letter of Head Printer Proposal
request to conduct the
project
Writing/ Sending February Proponent Laptop Approve
solicitation letters to 2020 School Bond Paper Project
Non-governmental (1st-2nd Head Printer Proposal
organization, Week)
stakeholder, known
individuals
B. IMPLEMENTATION
PERSON/S RESOURCE MEANS OF
ACTIVITIES TIME FRAME
INVOLVE REQUIREMENT VERIFICATION
Blood Donation Activity May 26, Proponent School Supplies Documentation
2020 School Head given by donors
Teachers
Stakeholders
Philippine
Red Cross
C. EVALUATION
PERSON/S RESOURCE MEANS OF
ACTIVITIES TIME FRAME
INVOLVE REQUIREMENT VERIFICATION
Prepare and submit February Proponent Laptop Accomplishmen
write-up of the conduct 2020 School Bond Paper t Report
of the activity (3rd Week) Head Printer

Address: Cardona, Gerona Tarlac

Telephone No.: 0919-993-9873
Email Address: 300959@deped.gov.ph
 Republic of the Philippines
Department of Education
REGION III
SCHOOLS DIVISION OF TARLAC PROVINCE
CARDONA NATIONAL HIGH SCHOOL

VII. BUDGETARY REQUIREMENTS:

A. Supply Needed:
Snacks for 50 persons
Juice drink for 50 persons
20 gallons of water
Gas allowance for Philippine Red Cross personnel
Certificates

B. Expected Total Budget:

4,000.00 php

VIII. FUNDING SOURCE:

Special Fund (Donors, Sponsorship or Partners from NGO and Private
Sectors/Stakeholder)

IX. EVALUATION PROCEDURE:

To assist with outreach assessment, this rubric has five different performance levels that
can assign to each current practice. Here are the following:
5 – Integrated (INT) – The Practice determined the best way to perform the practice and
systematized it, coordinating with other aspects of the project. A practice at this level
is proactive, valued and successful.
4 – Well developed (WD) – The practice has resources allocated, responsibilities are
assigned, and the process is managed. The practice may still not be completed
regularly, perfectly, or punctually, but it’s deliberate and proactive.
3 – In Development (ID) – The practice is unorganized, unassigned, and has a little to no
resources committed to it. A practice at this level is often performed in a reactive
(rather than proactive) manner.
2 – Not performed (NP) – The outreach program hasn’t been attempted by the school.
Practice at this level has been overlooked or set aside.
1 – Not applicable (NA) – The Practice is impractical or not a viable option for the
project.
Execution Description LEVEL
Practice INT WD DEV NP NA
Identify Who is leading
Collaborators or contributing?
Identify Mission Basic outreach
content
Define Target Key stake
Audiences holders, groups
Define Strategy Purpose
Project Use of Brief,
Management Work Plan,
Budget
Build Partnerships Strategic
Relationships
Analyze/Report Report value,
Status insights,
lessons
Adjust Plan Prepare for next
steps

Address: Cardona, Gerona Tarlac

Telephone No.: 0919-993-9873
Email Address: 300959@deped.gov.ph
 Republic of the Philippines
Department of Education
REGION III
SCHOOLS DIVISION OF TARLAC PROVINCE
CARDONA NATIONAL HIGH SCHOOL

X. MONITORING AND EVALUATION:

The proponent, school head, the School Disaster Risk Reduction and Management
Council, and the Red Cross Youth Council shall closely monitor and supervise the,
“Mobile Blood Donation Outreach Program: Safe blood saves lives and improves health.” An
evaluation tool will be used in this community outreach program in assessing the outcome
of the said outreach. With favorable results, the activity will be continued to give
student’s conscious attention and become aware of the Blood services and programs of
the community.

XI. EXPECTED OUTPUT:

The expected outputs of this community program are:
1. Participation in school / community activities;
2. The value and act of kindness, empathy and compassion to other people
have been installed on the minds of the students; and
3. Embracing the value of community service, care and concern for others
have developed.

Prepared by:

RENZ DOMINIC D. GONZALES

Teacher II

Noted:

ALEXANDER R. AMIGO
Principal I

Approved:

VICTOR O. SANTOS JR.

OIC-Chief Education Supervisor, SGOD

Address: Cardona, Gerona Tarlac

Telephone No.: 0919-993-9873
Email Address: 300959@deped.gov.ph
 Republic of the Philippines
Department of Education
REGION III
SCHOOLS DIVISION OF TARLAC PROVINCE
CARDONA NATIONAL HIGH SCHOOL

February, 2020

HON. ELOY C. ECLAR

Municipal Mayor
Gerona Tarlac

Sir/Madam:

Greetings in the Name of the Almighty God!

Cardona National High School is an educational institution that cultivates exceptional

values and prodigious culture in every learner. Hence producing good Christians and honest
Citizens that are actively involved in our community.

In line with this, the Cardona National High School in partnership with the Philippine
Red Cross, Tarlac Chapter is facilitating a Blood Donation Activity on February 26, 2020 from
8:00 to 11:59 in the morning, at the covered court of Brgy. Cardona. And it is our privilege to
request your presence in our advocacy of promoting safe blood donation and volunteerism.

May we ask for pledges from your office to provide representatives that are willing and
able to donate blood to be forwarded to the Philippines Red Cross Blood Center.

Attach herewith are the Guidelines in Blood Donation Program and the Pledge form to be
fill out by the volunteer donors.

We are look forward to your presence and support in the advocacy of making individuals
as regular voluntary unpaid donors to guarantee sufficient supply of safe blood and to meet
national blood necessities in the Philippines.

For direction, please contact our Blood Donation Outreach Program coordinator at 0917-
584-5074 and look for Mr. Renz Dominic D. Gonzales,

Thank you very much and may God bless you for your generosity.

Respectfully yours,

ALEXANDER R. AMIGO
Principal I

Address: Cardona, Gerona Tarlac

Telephone No.: 0919-993-9873
Email Address: 300959@deped.gov.ph
 Republic of the Philippines
Department of Education
REGION III
SCHOOLS DIVISION OF TARLAC PROVINCE
CARDONA NATIONAL HIGH SCHOOL

MOBILE BLOOD DONATION GUIDELINES

Background
The Philippine Red Cross is a humanitarian organization, which provides services to uplift the lives of
the underprivileged. One of its basic services is the Blood Services, which works on providing the country
with an adequate and safe blood supply from volunteer, non-remunerated blood donors.

Advantages of Voluntary Blood Donation

1. Safer and better quality of blood supply.
2. Regular donation from volunteers will help ensure adequacy of blood supply.

Benefit to the blood donor

1. Blood donation stimulates production of new cells.
2. Personal health check. You will know your blood type and hemoglobin.
3. Blood donation boosts personal self-worth

Qualifications of a Blood Donor

1. Age - 18 – 60 years old (61 – 65, regular donor)
- 16 – 17 years old must have parent’s consent

2. Weight - at least 110 lbs. (approximately 50 kg)

3. Blood Pressure - between 90 – 140 mmHg (systolic)
- between 60 – 100 mmHg (diastolic)
4. Pulse Rate - 50 – 100 beats per minute
5. Body Temperature - must not exceed 37 degrees Centigrade
6. Hemoglobin - 125 g/L (12.5 g/dL)
7. Medications taken, travel history, tattoo and piercing to be assessed if qualified to donate.
- Before the actual blood donation

Preparations before donating blood

1. Have enough rest and sleep.
2. No alcohol intake 24 hours prior to blood donation.
3. Medications taken, travel history, tattoo and piercing are to be assessed if qualified to donate.
4. Have something to eat prior to blood donation, avoid fatty foods.
5. Drink plenty of fluid like water or juice.

Steps in donating blood

1. Have your weight taken.
2. Answer honestly and completely the donor registration form.
3. Have your blood type and hemoglobin checked.
4. The physician will examine and determine an individual’s eligibility to give blood.
5. Actual donation: The phlebotomy procedure would usually take about 10 minutes or less.
6. A 10-minute rest and enough fluid intake is necessary after donation.

What to do after blood donation

1. Drink plenty of fluids like water or juice to replace fluid loss.
2. Refrain from stooping down after blood donation.
3. Refrain from strenuous activities like:
a. Lifting heavy objects
b. Driving big vehicles such as bus, trucks, etc.
c. Operating big machines
4. Avoid using the punctured arm in lifting heavy objects.
5. Apply pressure on the punctured site and lift the arm in case the site is still bleeding.
6. If there is discoloration and swelling on the punctured site, you may apply cold compress within the
first 24 hours then warm compress for the next 24 hours.
7. If there is dizziness, lie down with feet elevated until such time the uncomfortable feeling subsides.
Drink plenty of juice, in just a few minutes or so it will pass.

Address: Cardona, Gerona Tarlac

Telephone No.: 0919-993-9873
Email Address: 300959@deped.gov.ph
 Republic of the Philippines
Department of Education
REGION III
SCHOOLS DIVISION OF TARLAC PROVINCE
CARDONA NATIONAL HIGH SCHOOL

Frequently asked questions on Blood Donation

1. Will donating blood make me weak?

No, it will not make you weak. Donating 450cc will not cause any ill effects or weakness. The human body
has the capacity to compensate with the new fluid volume. Further, the bone marrow is stimulated to produce
new blood cells which in turn makes the blood forming organs function more effectively.

2. How often can a person donate?

A healthy individual may donate every three months.

3. Can a person who has tattoo still donate blood?

If the tattooing procedure is done a year ago, he/she may donate. This is also the same with ear piercing,
acupuncture, and other procedures involving needles.

4. How long will it take to donate blood?

The whole process of donating blood from the registration up to the time you rest will only take an average of
30 minutes.
The blood extraction will take about 5-8 minutes and the volume will be replenished within 24 hours then the cells
within weeks. Essentially, by the end of the month, the body will have the same amount of blood before the blood
donation.

5. Will, I contract disease through blood donation?

No, we use sterile, disposable needles and syringes.

Donor Counseling
In case a donor is found to be reactive to any of the 5 infectious diseases namely HIV, Malaria,
Syphilis, Hepatitis B and Hepatitis C, he or she will receive a letter and will be asked for a counseling session
conducted by a medical officer at the National Blood Center. The content of the session includes discussion
of the disease, its course and mode of transmission, prognosis and prevention.

How to avail blood from the PRC?

1. Kindly get a blood request form from the hospital where the patient is
admitted. The following details are needed:
- Full name of the patient
- Age, Sex, Status
- Blood type, Rh group
- Blood Component
- Amount/unit needed
- Diagnosis/Indication for transfusion
- Printed name with signature of the attending physician
2. Bring the blood request form to the nearest Red Cross Blood Center.
3. Blood processing fee – payment for the processing of blood to ensure safety of the patient; the amount
depends on the blood component.
4. Immediately bring the blood dispensed from Red Cross to the blood bank of the hospital.

Address: Cardona, Gerona Tarlac

Telephone No.: 0919-993-9873
Email Address: 300959@deped.gov.ph
 Republic of the Philippines
Department of Education
REGION III
SCHOOLS DIVISION OF TARLAC PROVINCE
CARDONA NATIONAL HIGH SCHOOL

BLOOD DONOR’S CONSENT FOR AGES 16 AND 17 YEARS OLD

I am voluntarily giving my blood through the Philippine Red Cross, without remuneration, for the use

of persons in need of this vital fluid without regard to rank, color, creed, religion or political persuasion. I

understand that all questions are pertinent for my safety and for the benefit of the patient who will undergo

blood transfusion. I understand that my blood will be screened for Malaria, Syphilis, Hepatitis B, Hepatitis C

and HIV.

I authorize the Philippine Red Cross to dispose my blood in any way it may deem advisable for the

safety of the majority of the populace.

I certify that I, to the best of my knowledge, will truthfully answer all the questions in the Donor

Interview Sheet.

I, as a parent/legal guardian with my signature allows ____________________________________

to donate blood.

_________________________________ _________________________________________

Signature of Donor over Printed Name Parent/Guardian’s Signature Over Printed Name

Address: Cardona, Gerona Tarlac

Telephone No.: 0919-993-9873
Email Address: 300959@deped.gov.ph
 Republic of the Philippines
Department of Education
REGION III
SCHOOLS DIVISION OF TARLAC PROVINCE
CARDONA NATIONAL HIGH SCHOOL

BLOOD DONOR’S PLEDGE FORM

Name: _________________________________________________________________________________________

Address: ______________________________________________________________________________________

_________________________________________________________________________________________________

Blood Type: __________________________________ Age: __________________________________________

Contact Number: __________________________Email Address: ________________________________

Office or Agency: _____________________________________________________________________________

__________________________________
Signature Over Printed Name

_________________________________
Date signed

You have the most precious gift of all, the ability to save lives!
Please give blood!
I will donate on _____________________.
“I am a blood donor, and I save lives!

Address: Cardona, Gerona Tarlac

Telephone No.: 0919-993-9873
Email Address: 300959@deped.gov.ph
 Republic of the Philippines
Department of Education
REGION III
SCHOOLS DIVISION OF TARLAC PROVINCE
CARDONA NATIONAL HIGH SCHOOL

MOBILE BLOOD DONATION FLOOR PLAN

Step 1: Step 2:

Registration Area Physical Assessment

Chairs Chairs

Chairs Chairs

Chairs Chairs

Water Water

Step 3:
Technician
Blood Extraction Area Area

Red Cross
Personnel

Cotbed Cotbed Cotbed Cotbed

Step 4:

Recuperation/Refreshment Area

Juice
Ambulance
Drinks

Chairs
Snacks
Chairs

Chairs

Address: Cardona, Gerona Tarlac

Telephone No.: 0919-993-9873
Email Address: 300959@deped.gov.ph
 Republic of the Philippines
Department of Education
REGION III
SCHOOLS DIVISION OF TARLAC PROVINCE
CARDONA NATIONAL HIGH SCHOOL

List of Partners and Participants

1. Mayor’s Office
2. Brgy. Cardona
2. MDRRMO
3. PNP Gerona
4. BFP Gerona
5. 2nd TAS, AFP
6. 3rd RCDG, PA
7. 302nd CDC, PA
8. MSWD
9. MEO
10. RHU 1,2,3
11. Corazon High School
12. Tagumbao High School
13. Buenlag High School
14. San Jose High School
15. Gerona Western High School
16. Quezon High School
17. Gerona Junior College
18. Ford Everest Club of the Philippines – Tarlac
19. GPTA
20. Parents
21. Grade 11 and 12 students

Address: Cardona, Gerona Tarlac

Telephone No.: 0919-993-9873
Email Address: 300959@deped.gov.ph