Diaper Drive 2025 Structure Build Commitment Form

Diaper Drive 2025 Structure Build Commitment Form
Company*
Main Authorized Contact Name*

First NameLast Name
Main Authorized Contact Email*
example@example.com
Main Authorized Contact Phone*
Please enter a valid phone number.
Secondary Authorized Contact Name

First NameLast Name
Secondary Authorized Contact Email
example@example.com
Secondary Authorized Contact Phone
Please enter a valid phone number.
Will you need electricity or other utilities for your build that you will need HomeAid to provide?*

YesNo
If, yes what utilities?
I, First Name*Last Name* , have read and understand that my signature, submitted on Date* , serves as a definite commitment on the part of my company to build and deliver a diaper structure at Diaper Drive 2025, according to the guidelines provided by HomeAid Orange County. I will comply with the rules provided by HomeAid Orange County. I understand that diaper reimbursement will be as needed and the remaining funds will be used toward our engagement programs.
Date*

MonthDayYear
Date
Signature of Authorized Contact*

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Campaign ID*
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