Conejo Community Outreach
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Diaper Bank Request Form

NEW CLIENT FORM

If this is your  first time requesting assistance from our diaper bank, please fill out the form below. First-time clients will need to provide additional documentation  before CCO can process the request.

If you have received assistance from the diaper bank before, please fill out the RETURNING CLIENT form. 

​If you are a representative from an organization, and wish to make a request on behalf of a client, please visit the ORGANIZATION REFERRAL page.

​For general information about our diaper bank and what to expect, please see our DIAPER BANK FAQ page.

Eligibility

Before we can process your order, we ask that your review our eligibility requirements below and email the requested documents to us for verification if you did not upload when submitting your form. If an alternative form of identification needs to be discussed, please email us.

In the email's subject line, please write: "FULL NAME - Diaper Bank Eligibility Documents" and send to:
board@conejocommunityoutreach.com. Upon receiving, we will confirm receipt of documents and begin processing your order.


CONFIDENTIALITY:  Under no circumstances is this information intended to be shared with anyone. These will remain confidential and are only for internal verification purposes in order to process your order. 
​
We do not require original or certified copies of this paperwork. It is acceptable to take a picture using your phone, and submit the images to us.

TO DOWNLOAD ELIGIBILITY REQUIREMENT INFORMATION:

In ENGLISH
In SPANISH
​

If the identification you provide does not show your current residency (e.g. a work badge), please also provide a picture of a recent bill addressed to you to confirm residence within County of Ventura. Thanks!


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Conejo Community Outreach (CCO) is an IRS-recognized 501(c)(3) nonprofit. EIN 47-5486486.

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  • Home
  • STORY
    • Press Releases
    • BLOG
  • Diaper Bank
    • Diaper Bank FAQ
    • New Client
    • Returning Client
    • Organization Referral
    • Diaper Bank Eligibility
    • Support the Diaper Bank
  • RESOURCES
    • CCO Scholarship
    • Past Events >
      • Community Thanksgiving >
        • Community Thanksgiving 2019 >
          • Community Thanksgiving 2020 >
            • Family Nominations 2020
          • Family Nominations 2019
        • Community Thanksgiving 2018
        • Community Thanksgiving 2017
        • Community Thanksgiving 2016
        • Thanksgiving 2015
      • Back to School
      • CLOSET DAY
      • Relay for Life
      • CCO Fundraisers >
        • Charity Karaoke 2019
        • Charity Karaoke
        • Holiday Family Photos Mini-Sessions
        • PARENTS' NIGHT OUT
        • Paint Nite
        • The Play Destination
        • Cronies Sports Grill
  • Gratitude
  • Donate
  • CONTACT