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Diaper Requests
Thanks to our friends at Western PA Diaper Bank we are able to provide diapers and baby wipes to restaurant folks in our group.
Please fill out the form below if you are in need of these items. We will send this information to our partners on Tuesday so we can accommodate folks order by Sunday.
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* Indicates required question
Name
*
Your answer
Phone Number
*
Ex. (412) 505 - 0000
Your answer
Email Address
Ex.
pghrestaurantma@gmail.com
Your answer
Where are you located?
*
City: North Side
City: South Side
City: East End
City: West End
County: East/Mon Valley
County: North Hills/Ohio River
County: South Hills
County: West/Airport
County: East/Allegheny River North
Other:
Address
*
Ex. 187 Lorelai Street, Pittsburgh, PA 15224
Your answer
How many kids do you have?
*
Please indicate the number of children along with the age
Your answer
What size diapers do you need?
*
Please list in detail so we can work on assisting you in the future.
Size N Diaper (up to 10lb)
Size 1 Diaper (8-14lb)
Size 2 Diaper (12-18lb)
Size 3 Diaper (16-28lb)
Size 4 Diaper (22-37lb)
Size 5 Diaper (>27lb)
Size 6 Diaper (>35lb)
Baby wipes
Baby food
Baby formula
Required
Would you need items delivered?
*
Items can be picked up on Saturdays from the Irma Freeman Center (5006 Penn Avenue, Pittsburgh, PA 15224)
Yes
No
Maybe
Comments and/or concerns
Your answer
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