Pads4Girls Partner Group Application
Please complete the following form to apply to become a Pads4Girls distribution partner. Pads4Girls distribution partners are able to purchase subsidized-cost kits of washable pads or period underwear for $5 each.
Please provide as much information as possible. After completing the application form, we will review your information and contact you.

Partner Groups must meet the following eligibility criteria:
-Group must be serving individuals in the global south
-Group must purchase a minimum of 50 kits
-Group must have a shipping address within the US or Canada

Organization Name *
Your answer
Website or Social Media URL
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Contact Name *
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Phone
Your answer
Email *
Your answer
Shipping Address *
Lunapads ships Pads4Girls Kits to the US and Canada only. Recipient groups are responsible for organizing transportation to final destination.
Your answer
In what country/region do you work? *
Your answer
How many people are you seeking to supply? *
Your answer
Describe the need and/or current conditions for those whose needs you are seeking to address. eg: How many are being impacted by lack of menstrual hygiene products? How many days per month are they staying home? What are the barriers to accessing hygiene products? *
Your answer
Do the potential recipients have the following (check all that apply) *
Required
How will you measure the success or impact of the donation? Will you have continued contact with the recipients after the kit distribution is complete? *
Your answer
How and when will the Pads4Girls Kits be delivered to the destination community? Who will provide the training in using and caring for them? *
Your answer
Is there a specific date by which you need Pads4Girls Kits delivered? *
Your answer
Please confirm your agreement to the following: *
Required
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