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 available Tuesdays 10am-12pm and Thursdays 9am-11am. Orders can be picked up from our warehouse 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. Every effort will be made to meet your order, but we are limited to supply on hand. Be aware that sizes vary by manufacturer.Preemie (Under 6lbs)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)Pullups 3T (18-34lbs)Pullups 4T (32-40lbs)Pullups 5T (38-50lbs) Δ