Eco Femme screening form
Eco Femme partners with NGOs and other organisations to provide cloth pads and deliver educational programmes that foster a healthy, responsible and dignified menstrual experience for women and girls throughout India.
Pads can be supplied in bulk in a number of different ways:
1. Freely to economically-disadvantaged adolescent girls via our pad for pad programme (sponsored by international customers)
2. Subsidised for NGOs and individuals to reach economically-disadvantaged women
3. Bulk rate discount for CSR funding and for foundations
We are committed to making sure that price does not become an obstacle and that free gifting, subsidies or discounts are offered based on genuine need. In order to help us evaluate your eligibility, we request you to fill in this screening form, return it to us, and we will be in touch shortly with a reply.
1. Your name: *
Your answer
2. Email address: *
Your answer
3. Organisation name: *
Your answer
4. Your position within the organisation: *
Your answer
5. Organisation website: *
Your answer
6. Organisation address: *
Your answer
7. Your contact phone number: *
Your answer
8. Is your organisation Non-Profit? (Yes/No): *
9. If Yes to the above question, please provide your organisation's status and registration number:
Your answer
10. In a few words, explain how you came to hear of Eco Femme and why you are interested in acquiring Eco Femme pads:
Your answer
11. How many pads would you initially be interested in having?
Your answer
12. Have you or someone in your organisation already used Eco Femme cloth pads? We strongly recommend that the person introducing cloth pads to your organisation either tries it herself or conducts some trials in small groups. Please let us know if this is a possibility.
Your answer
13. Who will be receiving the pads? Please describe/provide some demographic information the intended target group of pad users e.g. urban, semi urban or rural, age ranges, types of livelihood they are engaged in etc.
Your answer
14. What is your distribution strategy? How do you propose to reach out to the girls or women that you are working with? What, if any, is the current engagement of your organisation with this target group?
Your answer
15. Please indicate which of the options below would be of most interest to you in regard to funding and/or supply of pads to your target group:
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