Co-op Order Form: Bras and Breast Forms
Name
Your answer
How would you like us to contact you? *
if by telephone: can we leave a voicemail message? if email: please check your spam folder for our confirmation email!
Your answer
Item #1: What supplier would you like to use? *
We have only included two suppliers on the form, however we welcome you to choose a product from any supplier. Alternative products can be viewed at online stores such as theMastectomyShop.com or Breastformshopping.com (which carries more bras).
Item #1: What would you like to order? *
Please include the product name, product code, and/or include a link to the product's web page.
Your answer
Item #1: What colour, size, and style would you like? *
Please include all relevant size, colour, style, etc, information.
Your answer
Item #2: What supplier would you like to use?
We have only included two suppliers on the form, however we welcome you to choose a product from any supplier. Alternative products can be viewed at online stores such as theMastectomyShop.com or Breastformshopping.com (which carries more bras).
Item #2: What would you like to order?
Please include the product name, product code, and/or include a link to the product's web page.
Your answer
Item #2: What colour, size, and style would you like?
Please include all relevant size, colour, style, etc, information.
Your answer
Item #3: What supplier would you like to use?
We have only included two suppliers on the form, however we welcome you to choose a product from any supplier. Alternative products can be viewed at online stores such as theMastectomyShop.com or Breastformshopping.com (which carries more bras).
Item #3: What would you like to order?
Please include the product name, product code, and/or include a link to the product's web page.
Your answer
Item #3: What colour, size, and style?
Please include all relevant size, colour, style, etc., information.
Your answer
Every product in our Co-op is sold on a pay-what-you-can basis. We ask that you ask yourself what you are able to contribute based on your own needs and abilities and we are happy to receive that contribution in exchange for products ordered, what ever amount it may be (from 0$ to the cost of the product).
Depending on the number of requests you will either be placed on a waiting list or your product(s) will be ordered right away. Before we place your order we will contact you to confirm the details and will only place your order once we have confirmed with you. It will take approximately 2 to 5 weeks for your order to be received. Once your product is in, we will contact you and you can pick it up in our Co-op during our regular opening hours. *
If you indicated that your email address is your preferred method of communication, you should receive an automatic confirmation email after submitting this form. Please check your spam or junk mail folders! If you do not receive a confirmation email, please contact us at unionforgenderempowerment@gmail.com.
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