H.O.O.D Kit Request
For females ages 13-21
Name
Age
How did you hear about this program?
Which community do you live in?
Is this your first time requesting a kit?
Clear selection
You will receive a text or email updating you on your distribution date. Please provide your phone number or email address.
H.O.O.D Kits include hygiene products, period products, condoms etc. Items vary based on what we have in stock. We distribute every other week. Completion of this form will put you on the list to receive. There is no cost to you. :) Is there something in particular that you need?
Submit
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