Personal Care Pantry

Thank you for your interest in accessing the Personal Care Pantry at YWCA Allentown. We are open by appointment, Monday-Friday from 10am until 3pm. Please complete this referral form and we will call you to schedule a time to visit the Personal Care Pantry. We stock the following for women in our community: Shampoo and Conditioner, Soap and Body Wash, Tampons, Pads, and Reusable Feminine Care Products, Toilet Paper, Face and Body Lotion, Deodorant

Name(Required)

First Last

Preferred Name (if different than above)

Email(Required)

Phone

Please initial to confirm that you have read and agree with the statement below:(Required)

I understand that the Personal Care Pantry exists to provide assistance to people and families who really need that help. By accessing help from the pantry I affirm that my household genuinely needs assistance with personal care items.

Is there anything you would like us to know?

For Caseworkers and Referral Partners

If you are completing this form on behalf of a client, participant, or anyone other than yourself, please answer the following questions:

Your Name

First Last

Your Email

Name of your program, organization, business, or group

Is there anything you would like us to know?