601 For Period Equity Menstrual Product Request Form
601 for Period Equity's mission is to uplift Black menstruators and fight period poverty in the state of Mississippi. If you live in Mississippi and need access to menstrual care supplies, fill out the form below for products shipped to your doorstep!

Are you a school, shelter, or another community organization looking to provide menstrual products to those you serve? Fill out the form or contact us via email to request supplies!

Questions or Concerns? Send us an email or message via social media:

IG: @601forperiodequity
Twitter: @601period
Facebook: 601 for Period Equity
Email: 601forperiodequity@gmail.com
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Email *
Are you an organization or an individual requesting supplies? *
Name *
Phone Number *
Address (street name, city, state, zip code, etc.) Please provide a physical address (No P.O. Box) *
Where in Mississippi are you located? *
What products are you in need of? Select all that apply. *
If you feel comfortable sharing, do you or your organization have any other needs?
Additional questions, comments, or concerns
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