APPLY FOR A KIT
Beneficiary Intake Application
Please fill in ALL 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.
Note that the address that you provide will be the one we use to ship your kit – please ensure that it is COMPLETE (including your apartment number if it applies) and CORRECT.