Diaper Bank Partner Application
Agency Name:
Agency Address:
Agency Phone:
Contact Person Name(s):
Contact Person Email(s):
Contact Person Phone(s):
Diaper Bank Needs
Preemie
Newborn
Size 1
Size 2
Size 3
Size 4
Size 5
Size 6
Size 7
Size 2T
Size 3T
Size 4T
Size 5T
Adult Small
Adult Medium
Adult Large
Adult X-Large
Adult XX-Large
Adult XXX-Large
Adult XXXX-Large
Estimated number of donations made in a month?
Drop-Off Frequency
Once a Month
Every 2 Months
Only as Requested
How does the agency plan to distribute diapers to the community?
How will the community ultimately benefit from the agency distribution?
Are there any stipulations that diaper recipients meet certain qualifications in order to receive diapers? If yes, please describe in detail.
How will the agency recognize the Junior League of Mobile's partnership?
Note: Completion of application does not guarantee partnership.
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