Please completely fill out the information requested below. This information assists us in determining how we can best support you as well as how to put together a cloth diapering package that best suits your needs. All information that you provide is kept strictly confidential.
You can also download and print out the Beneficiary Intake Application PDF to submit by e-mail, fax, or mail.
You will also need to print out and sign the One Diaper Canada Beneficiary Waiver Form, to be uploaded with your application or sent to us via e-mail in order to process your application.