Mutual Aid Diaper Request Form
The TAA has partnered with the Village Diaper Bank and others to distribute diapers to student families. Please fill out the following form to communicate your diaper-related needs!

 NOTE: Requests and responses will be kept confidential.

Please only fill out the form once per month. If you need to change your requested size, please edit your form response (you will be emailed a copy of your response upon submitting the form) or email anthony.wp.flynn@gmail.com


Please put your preferred email for communication here.

NOTE: PLEASE DOUBLE CHECK TO MAKE SURE YOUR EMAIL IS WRITTEN CORRECTLY
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Email *
Secondary Email
Name (First & Last) *
Phone Number *
Academic Department
Is this your first time requesting diapers through this program?
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Do you have a child who attends the Eagle's Wing Child Care Program?
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How many children who use diapers do you have? *
Note: At this time, Village Diaper Bank can offer a maximum of 100 regular diapers or 50 pull-ups per child per month
Required
The following questions are about the diaper size(s) you need. In general, Village Diaper Bank provides us with 100 diapers or 50 pull-ups per child per month. However, their supply of Size 7 diapers is limited.

If you request after the deadline, there's no guarantee you will receive your diapers.
For child #1, what is your most-needed size? *
For child #2, what is your most-needed size?
For child #3, what is your most-needed size?
If you have more than 3 children, please indicate what sizes you need.
NOTE
Due to constraints from the Village Diaper Bank, our program can no longer reliably accommodate requests for unscented or hypoallergenic diapers or diapers from specific brands. However, if you are in need of/interested in cloth diapers as an alternative our partner, the Wisconsin Student Parent Organization (WISPO) can provide them! Feel free to contact them via email at wisporganization@gmail.com

A copy of your responses will be emailed to the address you provided.
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