Diapers The Corner Market Food Pantry is proud to partner with the United Way Diaper Bank to distribute free diapers to our GCC community. As part of this partnership, we must collect demographic information to fulfill report commitments and to be eligible for future support. Data is for informational purposes only and will not impact eligibility to pick up diapers. Data supplied will be aggregated to present in summary form in a report to United Way. Personally identifiable information (PII) such as name and ID will not be shared. All visitors who would like to pick-up diapers must fill this form out during or before your first diaper pick-up each academic year. "*" indicates required fields Name* First Last Student ID #Town of Residence*County of Residence*Race/Ethnicity* American Indian or Native Alaskan Black or African American Asian Hispanic or Latino/a/x or Spanish Middle Eastern or North African White Native Hawaiian and Other Pacific Islander Other/two or more races Unknown Please indicate the race/ethnicity of child or children needing diapersHousehold/Income* Household Size12345678 Annual Income Comments? Questions?Do you have any feedback or suggestions to share?