Community Partner Application - Emma's Diaper Boutique

1. Complete the application and submit to Emma’s Diaper Boutique via email emmasdiaperboutique@gmail.com.
2. The Emma’s Diaper Boutique reserves the right to decline applications based on a variety of criteria and community need.
3. During the application process a site visit and/or agency interview may be requested.
4. Please attach the applicable proof of your organization’s statue
  1. IRS Determination Letter (advanced ruling if applicable) showing 501(c)(3) standing with the IRS.
  2. Letter of Good Standing from National/Regional Headquarters (if applicable)
  3. Government Letterhead (if applicable)
Agency Name*
Mailing Address*
Address City State / Province / Region ZIP / Postal Code
Main Phone*
Website*
Program Name Using Diapers*
Program Contact Person and Title*
Email*
Phone number and direct extension:*
Program Description (This statement will be used to provide referrals for services and place on our website)
Executive Director’s Phone and Extension*
Executive Director’s Email*
Agency Mission
Diapers are stored and distributed from locations in Richland County. Will you be able to transport diapers from these areas to your programs?*
- Yes
- No
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