Period Pack Request 

You can only apply for yourself or on behalf of a child under the age of 16.
A period cup can take longer to be sent out, but you will get it.

What pack do you need-Please on pick one

If you are requesting a family pack please fill in below what each person needs & give their first name and age, if this info is not given then it won't be sent.
Please only select one pack per person

Person 2
Person 3

Thanks for submitting!