August 14th GUGP Period Products
Due to the overwhelming need in the community individuals must pre-register for each Market Distribution Day.

Please complete the following pre-registration form if you are in need of PERIOD PRODUCTS

*Please note we are limiting to pre-registration to 60 clients for period products.* 

We are doing our best to meet the needs within our community during this difficult time and we look forward to serving you.

If you register and do not show up TWICE, unfortunately we will not be able to accept your pre-registration for future market days. If you need to cancel please email us at info@graceupongraceproject.org
Email *
Untitled Title
Date *
MM
/
DD
/
YYYY
First Name *
Last Name *
Phone number (please no dash marks) *
City of Residence (used for grant purposes only) *
Household Size. A Household is defined as the total number of related or unrelated persons living at the same address. (Used for grant purposes only) *
Monthly Household Income. Household income is the combined income of persons claimed above. (Used for grant purposes only)
Clear selection
Products--You may choose up to a total of three different products. (please note if we are out of something we will substitute it with something to ensure your needs are met) *
Required
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