April Pick-Up Form

Pick-Up Form

Please fill in the April pick-up form below to schedule when you would like to get items for your child(ren). We have items for children ages Newborn - 4 years old. Item supply is based on donations. This form is ONLY for this month.
PLEASE NOTE OUR TO-GO SERVICE IS LEAVING STARTING MAY 1ST.

IF YOU HAVE QUESTION PLEASE CALL OR TEXT OUR OFFICE AT (315)437-8300
Name

First NameLast Name
Phone Number*
Please enter a valid phone number.
Email*
example@example.com
How did you hear about us?
Can we contact you? (select as many as you wish)

TextCallEmailPlease do not contact me
How Many Children Will You Be Picking Up For?
Please list each child's first and last name and date of birth. (Only 5 years and younger)
Pick-Up Date*
If the calander is not working (is completly greyed out), please write the day and time you would like to pick up in the additional notes at bottom of the page. Pickup times are from 9AM to 4PM Mondays, Tuesdays, and Fridays on the half hour.

If an item or item size is greyed out that means we do not have it, we apologize for the inconvenience.

My Products

Wipes1 Pack Per Family

$ Free

Girl's ClothingPlease select all GIRLS clothing that you need. If you do not need clothing, please skip this question as we have a limited supply.

$ Free

Size	For How Many Children?
Newborn
0-3mo
3-6mo
6-9mo
12mo
18mo
2T

Boy's ClothingPlease select all BOYS clothing that you need. If you do not need clothing, please skip this question as we have a limited supply.

$ Free

Size	For How Many Children?
Newborn
0-3mo
3-6mo
6-9mo
12mo
18mo
2T

FormulaPlease select what formula you need. If you do not need formula, please skip this question as we have a limited supply. If out of stock, we may substitute an equivalent formula. Check with your pediatrician before switching brands.

$ Free Quantity

Diapers

$ Free

Size	For How Many Children?
NB
1
2
3
4
5
6
2T-3T
3T-4T
4T-5T

Total

$0.00

PICKUP AT NEW HOPE FAMILY SERVICES - 3519 JAMES ST. SYRACUSE, NY 13206

If you cannot make your appointment, please call or text 315-437-8300 before your scheduled time.

We will only hold the order for 3 business days! After that time, we cannot promise that we will be able to complete your order.
Any Other Notes?
OUR TO-GO PROGRAM IS ENDING MAY 1ST. ALTERNATIVE WAYS TO GET DIAPERS INCLUDE: CARE CORNER APPOINTMENTS, PARENTING CLASSES, BIBLE STUDIES, AND WORKSHOPS

Please call or text us at 315-437-8300 to schedule an in-person appointment.
Should be Empty:

Pick-Up Form

OUR TO-GO PROGRAM IS ENDING MAY 1ST. ALTERNATIVE WAYS TO GET DIAPERS INCLUDE: CARE CORNER APPOINTMENTS, PARENTING CLASSES, BIBLE STUDIES, AND WORKSHOPS