British Columbia and Yukon Community Product Request Form 2024 
Moon Time Connections is an organization who gathers Moon Time products and ships them to northern communities completely free of charge.

This form is to request menstrual products for your northern Community. 

When filling the form, please be as specific with your shipping address as possible. 

Should you have any other requests or questions, please contact your Chapter Lead, Neha Menon at mtc-bc@truenorthaid.ca 

Note: If you do not receive product within a month of requesting them, please email your Chapter Lead
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What Community is requesting items?  *
What is your name?  *
What is the best email to reach you at? *
What is the best phone number reach you at?  *
What is the shipping address? 
Please include all necessary shipping information including postal code, and a complete street address in addition to a PO Box (if applicable) 
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Please re-enter your postal code.  *
What is your relationship to the community?*
Are you a member, a teacher, doctor, nurse, or other professional in the community?
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Required
Which airlines fly cargo into your community?
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Roughly how many people who menstruate are in your community?
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Please indicate which products you would be interested in receiving. Please note all reusable items are new and unused.
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Required
We know storage can be an issue at times. Are you able to accept a pallet or more worth of product? Please know you are able to share these items with other Community programming as well and request more when you are low. There is no limit on how many times you request items. 
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Are you interested in free wall mounted dispensers  for your programs washrooms from our partner joni? If yes, please indicate how many you would like 
Do you have access to a loading dock? *
Is a power tailgate needed to deliver products? *
Is there access for a 53ft trailer? *
Are you interested to learn more about Moon Time Connections available Education Programming? 
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By submitting this form and checking the box below, I do hereby declare that I will ensure donated products will be provided to community members free of charge as per the Moon Time Connections mandate.
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Required
By submitting this form and checking the box below, I understand and agree that True North Aid and Moon Time Connections are not liable for any injury in relation to the above activities 
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Required
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