Application Form for EC Challenge Group

Thank you for your interest in Elimination Communication Challenge Group, a program of the Ditch the Diapers Zero Waste Initiative by Diaper Stork and Re-ThinkGreen. This group will be a support group and marketing powerhouse all in one. Participants will join 10-12 other families with newborns as they learn to preserve their babies' natural instincts to eliminate away from their bodies. We're looking for passionate people who are excited to get $40 off cloth diaper service and are willing to be part of the testimonials, photos & videos that will start an EC movement in Seattle. Ready to get started? Fill out this application survey by September 22, 2019.

Question Title

* 1. Basic Info

Name:

Facebook/Instagram/Pinterest handle, if any

City/Town

State/Province

ZIP/Postal Code

Email Address

Phone Number

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* 2. Participants in this group will have newborn babies. What is your baby's birth date / due date?

Date / Time

Date

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* 3. We will have monthly group meetings in Seattle. Over the next 9 months, how often will you be available at the following days/times? (Transportation will be provided if needed.)

	Never / almost never	Sometimes	Almost Always
weekday mornings	weekday mornings Never / almost never	weekday mornings Sometimes	weekday mornings Almost Always
weekday afternoons	weekday afternoons Never / almost never	weekday afternoons Sometimes	weekday afternoons Almost Always
weekday evenings	weekday evenings Never / almost never	weekday evenings Sometimes	weekday evenings Almost Always
Saturday mornings	Saturday mornings Never / almost never	Saturday mornings Sometimes	Saturday mornings Almost Always
Saturday afternoon/evenings	Saturday afternoon/evenings Never / almost never	Saturday afternoon/evenings Sometimes	Saturday afternoon/evenings Almost Always
Sunday mornings	Sunday mornings Never / almost never	Sunday mornings Sometimes	Sunday mornings Almost Always
Sunday afternoon/evenings	Sunday afternoon/evenings Never / almost never	Sunday afternoon/evenings Sometimes	Sunday afternoon/evenings Almost Always

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