I've Been Mended Inc NP Requisition Form

Baby Furniture Requisition Form

Request free baby furnishings for your children. Please txt for updates or questions: Phone: 779-702-2766; Email: IveBeenMendedInc@gmail.com; Website: www.ivebeenmended.org; www.facebook.com/IBMOrganization.
We will contact you within 24 hours or the next business day. Please check your email and text #. If you've not received communication from us please feel free to text us with your name and child's age so we can search for your request & update you. Our office hours are Wednesday, Thursday, and the second Saturday of the month from 11:15 a.m. to 2:00 p.m. After approval, you may pick up baby furnishings between 11:30 a.m. and 1:45 p.m. on Wednesday or Thursday only. If you cannot pick up your baby furnishings, you may text 779-702-2766 with the full name, last name, and phone number of the person who will pick up the items for you. If baby furniture is not picked up and no communication attempts has been made it will be awarded to the next mother in need. We take pride in servicing our mother's it is a honor. In the event that we are not able to provide for you please call 211 on your cell or landline phone and ask for assistance please let them know IBM Inc NP referred you.

Thank you,

Dr. Daphney AAS BA Con MA IOP DCL CCC CLC Found-CEO Executive
Applicant Information
Full Name

First NameLast Name
Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Address

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Reason for Request / Hardship or Emergency
FYI: Our staff and volunteers may assist with unloading items into the building; however, you are responsible for loading all furniture into your own vehicle. We do not provide transportation and cannot load items into vehicles.
Please explain your reason for the request and describe your hardship or emergency in detail.
Child Information
Child #1 Name
Child #1 Date of Birth

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Child #2 Name
Child #2 Date of Birth

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Identity and Address Verification
Upload photo of your State ID or Driver's License showing your current address

JPG, PNG, or PDF
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Upload photo of a piece of mail showing the same address

JPG, PNG, or PDF
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Separator
Proof of Child
Type of Proof of Child

Other
Upload Clear Photo of Proof of Child

JPG, PNG, or PDF
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Separator
These items are free, donated baby furnishings provided solely for the personal use of the requesting family. They may not be traded, sold, or transferred to any other person or organization.
Requested Baby Furniture Items (maximum of three)
Select up to three (3) baby furniture items you are requesting
All baby furnishings provided through this program are new, donated items from outside sources and are offered as-is, without any warranties or guarantees. I've Been Mended Inc., its officers, directors, staff, and volunteers are not liable for any injuries, damages, or harm that may occur from the use, assembly, transport, or condition of any baby furnishings received. By submitting this form, you acknowledge and accept full responsibility for the safe use of all items provided.
Limit: Only three (3) furniture items allowed per family.
Email Address
example@example.com
Should be Empty:

Baby Furniture Requisition Form

Applicant Information

Reason for Request / Hardship or Emergency

Child Information

Identity and Address Verification

Proof of Child

Requested Baby Furniture Items (maximum of three)