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International Programs

Folder: Resources

MPDP Application

Apply here to begine receiving free menstrual products from The PATESI Foundation

PLEASE COMPLETE THE FORM BELOW

Name of Recipient *

First Name

Last Name

Email *

Phone *

(###)

###

####

Address of Recipient *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Line

Are these products for yourself or someone else? *

For myself

For someone else

How many people in your household need products? *

1

2

3

4+

What types of products are you interested in?

Pads

Tampons

Menstrual Cups

Menstrual Discs

Wipes

Period Underwear

Maternity Pads or Depends

If we do not have your product preference available, would you still like a delivery of other menstrual products that we have in stock? *

Yes (if so, let us know your preferences below)

No

Would you like to be added to the waitlist for products that are out of stock?

Yes

No

Let us know below if you have any other suggestions or ways we can help end period poverty.

You can also add anything else you would like for us to know for your application.

Thank you for your application! We will get in touch with you soon.

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First Name

Last Name

Email Address

Thank you!

Our organization is committed to utilizing your gifts and donations to provide effectual and sustainable services and products in an effort to best serve the needs of our target populations.

The PATESI Foundation is an IRS registered 501(c)(3) and your donation is tax-deductible within the guidelines of U.S. law.

The PATESI Foundation is now a Google for Nonprofits entity and a verified nonprofit on Facebook.

All Rights Reserved.