Loving Bottoms Diaper Bank Ambassador
As an Ambassador, you will help collect diapers for West Central Illinois families by serving as a drop-off location in your neighborhood. With your support, families in your neighborhood will have an easy way to donate their unused, clean diapers/products!

In addition, Ambassadors help spread the word of this important work by sharing stories and information about our mission and work with local mom groups, listservs, schools, religious communities, etc.

This is a great way to meet other families in your community, as well as teach your own children or grandchildren about the importance of volunteering and community engagement -- all while providing a much needed basic resource to thousands of West Central Illinois families in need.
Name *
Date *
MM
/
DD
/
YYYY
Which type of ambassador? *
Email *
Phone number
Address *
City *
State *
Zip Code *
Special instructions for this diaper drop-off location? (hours of operation, location of the diaper collection box, etc...)
If you would like to have a second address listed as a drop-off location, tell us about it here (address, business name, etc.)
Submit
Never submit passwords through Google Forms.
This form was created inside of Loving Bottoms Diaper Bank.