You can only apply for yourself and others that live in your house that are under 18years old and need a periodcup We are requesting information (age etc) for stats only.  
If your request a period cup & a period pack we will only send one for that person.

Menstrual Cup
Which gender identity do you identify with
Please select which applies to you: (You can select more than one item. )
Please select which applies to you:

Please use the following information to pick what size cup would be best for you:

 

Size small : Size: 4.2cm by 7cm Holds 22ml

  • Perfect for first time users

  • Users aged 11-17 

  • Those who use smaller/light tampons or pads.

Size Large : Size: 4.6cm by 8cm Holds 29-30ml

  • Perfect for those who have heavier flow

  • Given birth,

  • Prefer to use larger size/heavy or use bigger pads and tampons.

What size cup do you need

Please only request a period cup for anyone under 18  in your household that needs one, please fill in each person full name and age, If this info is not given then what you have requested for them will not be sent. If you need to request a period pack for people In your house you will need to fill out the period pack request form after you submit this one.

Youth 1:What size cup do you need
Youth :2 What size cup do you need
Youth 3 :What size cup do you need

To help us save on postage we will send everything together so please let us know if you have requested a period pack for someone in your house.

Have you requested a period pack for anyone else in yur houose?"

Thanks for submitting!