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Donation to benefit a third-party organization (US & Canada Only)
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Donation to benefit a third-party organization (US & Canada Only)
Name
*
Last Name
*
Organization Details
If you are an individual please type NA
Website
Facebook
Instagram
Twitter
Other
Telephone
*
Email
*
Is there a local shelter or food bank that you are working with to distribute the cups?
Yes
No
Name Of Organization
Website
Facebook
Instagram
Other
Does the organization you want to support engage in primarily street outreach or shelter-based work? Please explain.
Has the organization you are looking to donate to been contacted and are able to accept menstrual cups?
What items are you requesting for donation? (Tick all that apply)
Model 0
Model 1
Model 2
Demonstration Kits
Educational Materials
Model 0 Amount
Model 1 Amount
Model 2 Amount
Demonstration Kits Amount
Educational Materials Amount
How will The DivaCup be distributed?
Does the organization you are looking to donate to have access to showers/washroom facilities at all times?
Is your organization open to sharing media (pictures, videos, blogs) with DivaCares for the purposes of promoting your initiatives on our social media channels?
Yes
No
Δ
