Website Partner Form Request

Is your organization a registered 501(c)(3)?

Yes

No

Organization Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Phone Number

Country

(###)

###

####

Point of Contact Name:

First Name

Last Name

Point of Contact Phone:

Country

(###)

###

####

Does Deborah’s Place Inc. have a current MOU (Memorandum of Understanding) with your organization?

Yes

No

Unsure

A. Baby Clothes

0-3 months

3-6 months

6-9 months

12 months

B. General Clothing

Youth - Boys

Youth - Girls

Adult - Men

Adult - Women

C. Hygiene Items

Soap

Toothpaste

Toothbrushes

Deodorant

Feminine Hygiene Products:

Shampoo/Conditioner:

Diapers (sizes):

Household Goods

Cleaning Supplies

Kitchen Essentials

Bedding

Food Assistance

Non-Perishable Items (Canned Goods, Pasta, Rice, etc.)

Fresh Produce (if applicable)

Baby Formula

Other

Preferred Delivery/Pickup Method

Pickup from Deborah’s Place

Delivery (If available, subject to scheduling)

Preferred Date

MM

DD

YYYY

Preferred Time

Hour

Minute

Second

AM PM

Agreement & Submission *

By submitting this form, I confirm that the requested items will be used to support the communities we serve and will not be resold for profit. Deborah’s Place Inc. is committed to transparency and accountability in our community partnerships. To ensure that donations are being utilized effectively and making a meaningful impact, we will provide an Annual Impact Report at the end of each year. This report will outline the distribution of donated items, the number of individuals and families served, and the overall impact of our collaborative efforts. By submitting this request form, you acknowledge and agree to receive our Annual Impact Report, highlighting the difference we are making together.

I Agree