Agency InformationThis form is for our registered partner agencies only. If you are an individual in need of diapers, please visit our Need Diapers? page. The Bundles of Hope team must receive this form at least 7 DAYS PRIOR to the requested pickup date. Orders not received by the deadline cannot be filled.Agency Name* Contact Name* Email* Phone*Requested Pick-up Date* MM slash DD slash YYYY Requested Pick-up Time* Pick up is ONLY available Tuesdays & Thursdays 9am-12pm. Please ensure you did NOT enter a date outside the stated days of the week. Orders are picked up from our warehouse located at 1430 Reverend Abraham Woods Jr. Blvd, Birmingham, AL 35203. CommentsPlease include any special concerns, as this form is shared with those who fill requests.Diaper RequestsPlease enter the number of bundles needed for each size. REMINDERS >>> Each baby is served with 2 bundles-odd number requests can not be filled. The maximum allowed order for sizes 4, 5, & 6 must not exceed 150 bundles total. Every effort will be made to meet your order, but we are limited to supply on hand. Be aware that sizes vary by manufacturer.Newborn (Under 10lbs)Size 1 (Under 14lbs)Size 2 (12-18lbs)Size 3 (16-28lbs)Size 4 (22-37lbs)Size 5 (Over 27lbs)Size 6 (Over 35lbs)Period RequestsSelect the appropriate order size to meet the needs of women & adolescents you are serving. If one does not meet your population needs, you are able to select multiple sizes. Orders are filled based on inventory availability. Pad Order Size Small (serves 25 clients) Medium (serves 50 clients) Large (serves 100 clients) Tampon Request Yes Δ