The YSEF Impact Foundation's Period Packet Program provided by HSDB

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The York Suburban Education Foundation Impact Foundation is happy to be partnering with Healthy Steps Diaper Bank to provide Period Packets.

* Below are the required questions from Healthy Steps Diaper Bank for us to fulfill your order. *

****The order form must be completed by Wednesday, May 15th at 12 pm (noon). The period packets will then be available to pick up at our Thursday, May 30th distribution. (Feel free to pick up your packets at the same time as your pantry order.) Dates will vary each month.****

IMPORTANT PERIOD PACKET INFORMATION: IF YOU HAVE MORE THAN ONE MEMBER IN YOUR HOUSEHOLD WHO NEEDS A PERIOD PACKET, YOU NEED TO SUBMIT A SEPARATE REQUEST FOR EACH PERSON.

Email *

Contact Information: First and Last Name (person receiving order at distribution) *

Contact Information: Home Address *

Zip Code *

Contact Information: Phone Number *

Race *

American Indian or Alaska Native

Asian

Black or African American

Native Hawaiian or Pacific Islander

White

Two or More Races

Ethnicity *

Hispanic or Latino

Non-Hispanic or Non-Latino

Military Status *

Non-military/spouse

Active Military/spouse

Retired/spouse

Reserve/spouse

National Guard/spouse

Currently receiving Diapers from HSDB? *

Yes

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