Child Parent Institute Diaper Bank Baby Essentials Request Form
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https://goo.gl/forms/sfSGKI1Y4hcTdErX2

Diapers are as essential to a child's basic needs as food and shelter. Yet, state and national safety net programs do not recognize diapers as a basic need. According to the National Diaper Bank Network, low-income families spend up to 20% of their monthly income on diapers and they often have to choose between food, rent or diapers. On average, diapers cost a family $70-80/month per child and 1 in 3 families have reported a diaper need.
Last year, CPI started Sonoma County's first DIAPER BANK and can now provide Sonoma County families who are in need with diapers, wipes and other baby essentials.

Please fill out this form to request diapers, wipes and/or other baby essentials.

After submitting the form, you will receive an email confirmation explaining where and when you can pick up your requests. If you don't receive an email within 3 business days, please contact jessicag@calparents.org

The answers provided on this form are for grant purposes and will not factor into your eligibility to receive diapers. Child Parent Institute Diaper Bank provides 70-96 diapers per child every 30 days. You will need to fill out an application in its entirety each time you experience diaper need. The form must be fully completed in order for your request to be processed. Fraudulent applications as well as resale of any distributed diapers or diapering supplies will result in termination of eligibility for our Diaper Bank services.

Email address *
I hereby acknowledge that I have read, understand and agree to the terms of this form relating to services of Child Parent Institute Diaper Bank. *
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