Thank you for taking the time to complete YWCA's Wholesome Hygiene Program intake form. This is a first come first serve donation service designed to provide basic hygiene items to individuals or families who can not afford these items on their own.

**One request per household, every other month limit. Toothbrushes and hairbrushes are provided every three months only.

The YWCA will be in contact with you soon! If you have questions regarding the intake form please give us a call at (402) 434-3494 Ext.111 or ask for Courtney at (402) 309-4153. Thank you!