Request form special campaigns

Thanks for visiting Eureka Mums!

To access our services all caseworkers, social workers and maternal and child health nurses must be registered with Eureka Mums. If you are not yet registered, please register here prior to completing this form.

This form is to be used for special campaigns where you ask for certain items for multiple families, like "back to school", "one mother to another", etc.

For normal orders with one form for each family and the regular scope of items, please use this form.  

For further assistance or for emergency requests, please contact the Social Services Coordinator via email

We look forward to receiving your request soon - thank you for your support of families in need.

Your Details

example: 0400111333

Family Information

Items Required

Please enter the number of required items next to what you require. Please note we rely on donations, so we cannot guarantee supply but we'll do our best.

Opening Times

Our opening hours for collections are: Tuesday and Thursdays 10am - 12pm. Mondays and Wednesdays 1:30pm - 2:30pm

Criteria for collection:

  • Pick up must be at least 5 business days from date of order. This is to give us enough time to prepare stock for you.
Looking forward to receiving your request soon - thank you for your support of families in need.