Date (enter today's date) ! Name of the Organization ! The organizaiton's URL ! Organization's address: Number and street name ! Organization's: City ! Organization's: State ! Zipcode ! Name of Contact in Organizartion ! Email of Contact. ! Number of baby wipe packs that are needed per month per baby? ! Number of baby wipe packs that are needed per year per baby? ! Number of babies from your organization who are in need of baby wipes per year? ! What state or states does the organization service? ! Nothing selected North CarolinaSouth CarolinaVirginiaTennessee What city or cities does the organization service? ! Nothing selected GreensboroHigfh PointWinston SalemClemmonsJamestownKernersvilleRaleighCary / ApexSpartaJeffersonWest JeffersonBooneOther(s) What city ore cities does the organization service? About how many baby wipes (packs) are used monthly by this organization? ! 17 to 20 21 to 24 25 to 27 28 to 30 About how many packs of baby wipes are needed per year? ! 200 to 210 211 to 220 221 to 230 231 to 240 What brand(s) are used mostly by families in need? ! Please Wait Submitting the form
