DIAPERS & BABY SUPPLIES REQUEST FORM
*For the form in Spanish, click here:
Dear parent, if you are filling out this form, you are probably experiencing hardships in providing for your family. Please know that you are not alone. The pandemic has put many families in a difficult situation. We are here for you and will make every effort to help you.
Our Marin Diaper Bank program is funded entirely by donations. This form doesn't guarantee that you will receive the requested items as we do have a limited amount of donations, however, we may be able to provide help now or in the future as more donations come in.
Families can request diapers for their children once a month. A new form must be completed for each request. After submitting the form we will contact you to the email you provide to let you know where and when you can pick up your diapers.
If you have any questions or need further assistance, please contact us at
Terms and Conditions
Fraudulent applications, as well as resale of any distributed diapers or diapering supplies, will result in termination of eligibility for our Marin Diaper Bank program services. The answers provided in this form are for grant purposes and will not factor into your eligibility to receive diapers and baby supplies.
I acknowledge that I have read, understood, and accepted the terms of this form related to the services of the Postpartum Support Center Marin Diaper Bank program
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This form was created inside of Postpartum Support Center.