Jillian's Drawers Diaper Service Sign-Up Form
Thank you for choosing our Diaper Service! If you have not already, please text us at 607-272-1237 to verify that your address is in our service area (typically within 12 miles of Ithaca, with some exceptions). Please use this form to provide the necessary account details we will need. All Diaper Service accounts also require a credit card to be kept on file for all charges and as a security measure against return of the diapers. Please call or stop by to provide your card information. Thank you!
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Email *
Name (primary name on your account): *
Phone number: *
Email address: *
Baby's Due Date *OR* Current Weight of Baby *
Delivery address: *
Tips for Driver (i.e. color of house, if tricky to find it, landmarks, tips): *
Delivery location (i.e. front door, porch, inside garage, etc.): *
Are you interested in adding cloth wipes to your weekly service for an additional $5/week? *
You're almost there...
Thank you for signing up! We typically make your first delivery about 3 weeks before your due date, so that you have diapers ready for your baby's arrival. After that, we wait to hear from you as to when to "activate" the service (so, week 1 is stretched out until we come back a second time). Delivery days are Wednesdays; we ask that you have your used diapers out, with tag looped loosely around the top of the bag, by 8:30am on Wednesdays. We will be in touch to be sure all your questions are answered. 
A copy of your responses will be emailed to the address you provided.
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