About

 
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The answers provided on this form are for grant purposes and to determine the volume of diapers needed for ongoing Camp Fire Support.  It will not factor into your eligibility to receive diapers. Butte Diaper Bank provides 50 diapers per child/adult and/or 25 Pull-Up's per child.

You will need to fill out an application in its entirety each time you experience diaper need. The form must be fully completed, meaning each question must be completely answered such as full name, child's full name, dates of birth, etc. in order for your request to be processed. Fraudulent applications will result in termination of eligibility for our services, as will resale of any distributed diapers or diapering supplies.

You may call (530)592-0882 for each monthly distribution date and time.  You can also find this information on our Facebook page.   Location, date, and time is subject to change due to weather conditions or volunteers schedules. We are currently attempting to maintain distributions on the last Saturday of each month from 9 am - 11 am.

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* 1. All of the information I am providing on this application is true and correct to the best of my knowledge.  I understand that Butte Diaper Bank reserves the right to verify this information and if determined to be fraudulent myself and/or child(ren) will no longer be eligible to receive diapers or diapering supplies.

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* 2. Please enter today's date

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* 3. Contact Information

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* 6. Si solo habla español:

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* 7. What source(s) of income does your household receive? Please check all that apply.

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* 10. What additional diapering supplies are needed?  (Please note - these items are subject to availability)

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