Tulsa Period Pantry Application

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Please fill out this form to apply for the Tulsa Period Pantry program. We will reach out to you soon to make arrangements to drop off your period pantry or let you know you are on the waitlist.

Your Name *

What is your position at the school? *

Your Best Email Address

At what school(s) do you serve? *

What is the drop off location address? *

Are there any special drop off instructions?

Which age range(s) do you serve? (Choose all that apply) *

Elementary

Middle

High

Required

How many female students attend your school(s) that would be menstruating age range? (Please provide most accurate information based on enrollment numbers for all grades that you would consider menstruating age range. EX: Elementary school may just be 4th and 5th graders, where MS and HS may be all females enrolled.) *

BEFORE partnering with Tulsa Period Pantry to what extend did students have access to period products at your school? *

None

Only what I or other teachers/staff personally provided

We partnered with some programs/organizations, but they were unreliable.

What were challenges that your school/students faced due to lack of access to period products BEFORE partnering with Tulsa Period Pantry? (Check all that apply) *

Students missed class trying to secure needed period products.

Students would need products, but none were available to give.

Students would be absent due to not having appropriate period products.

Students showed concern or distress about not having access to period products.

Required

Is there anything else you would like us to know?

Submit

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