Diaper Bank Request Form
NEW CLIENT FORM
- FIRST TIME: If this is your first time requesting assistance from our diaper bank — you are on the correct page. Please fill out the form below. First-time clients will need to provide additional documentation before CCO can process the request.
- RETURNING CLIENT: 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.
PLEASE NOTE: Our diaper bank is located in Newbury Park, California, and clients will need to be able to pick up their diapers in Newbury Park or make arrangements for someone to pick up on their behalf.
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 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 via email.
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!
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 via email.
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!