Helping Mamas Knoxville Partnership Screening Form

Thank you for your interest in partnering with Helping Mamas! We are the baby supply bank for Georgia & East Tennessee. Our mission- Helping Mamas elevates the well being and diginity of women by providing diapers, period products and other essential baby supplies. We harness the power of community support so that all families can thrive. We provide these items through several different distribution methods outlined below.

Baby Supply Program

Working with over 75 partner agencies throughout East Tennessee we provide critical items like diapers, wipes, car seats, cribs, pack and plays and more. We provide items for children birth to age 16. We are donation based so inventory fluctuates.

How does the partnership work?
If your organization is selected to become a partner with Helping Mamas, a partnership agreement will be executed between your organization and Helping Mamas before any items can be distributed to your organization. Clients are not allowed to pick up items from our facilty. Only verified staff members from a partner agency. Helping Mamas Knoxville DOES NOT deliver product to agencies.

Please answer the following questions below to help us determine if your organization will be a good match for our programs.

Agency:*

Contact Name:*

First NameLast Name

Phone Number:*

Please enter a valid phone number.Format: (000) 000-0000.

Email:*

example@example.com

Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Website address:

Social media links:

When was your organization established?*

What type of agency is your organization?*

Organization Yearly Budget?*

YesNo

Please upload the federal letter of determination from the IRS stating that your organization is exempt from Federal income tax under section 501 (c)(3) (or equivalent). NOT THE STATE OF TENNESSEE TAX EXEMPT FORM.*

What is your organization's mission/purpose?*

What type of program/services does your organization provide to individuals:*

How many clients do you serve on a yearly basis?*

Do you have storage space for bulk items?*

Which county/counties does your organization serve?*

Press and hold CNTRL key to make multiple selections

YesNo

What is your client referral process?*

Who can we refer to you? Ex: Only teen moms, expectant moms, 0-3 children, All families*

What items are your clients in need of?

Press and hold CNTRL key to make multiple selections

How often would you need items from Helping Mamas?

YesNo