Memorial University DivaCup Application

JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.

Intersections: Resource Centre for Marginalized Genders is proud to partner with DivaCup to provide free DivaCup products to MUNL students. To apply for this program, please fill out the application below. Application responses will be visible to Intersections volunteers only.

Decisions are made based on individual need and if we believe a DivaCup is the right choice for your needs. If you are not eligible to receive a DivaCup, please note that Intersections provides various menstrual hygiene products free of charge.

This program is only available to MUNL students. Please provide a MUN email to confirm your eligibility.

Email *

Is the MUN email provided the best way to contact you? *

Yes

If no, how should we contact you?

What name and pronouns would you like us to contact you under? (eg. John Doe, they/them)
*

Are you currently located in the St. John's metro area?
*

Yes

If you selected "No", would you be able to come to the St. John's MUNL campus to collect a cup?

Yes

Clear selection

As a requirement of the DivaCares program, a volunteer will review safe DivaCup insertion and removal techniques, as well as cup maintenance. These demonstrations are referred to as 'fitting sessions'.

Are you comfortable attending a session with a volunteer who will review these concepts with you?

Yes

Are you willing to complete a Doodle survey for dates/times of fitting sessions?

This form will be provided via your preferred contact method following the review of your application.

Yes

What cup size would you require?
*

Size 1 (18+, medium flow, has not given birth)

Size 2 (30+, heavy flow, has given birth)

Do you have an IUD?
*

Yes

Do you feel comfortable touching your genital region, including inside your vagina?
*

Yes

This free fitting is possible via DivaCares. As such, we are looking to make promotional content with these fittings. Would you be willing to make a statement, have a photo taken, or file a review for this experience after your fitting?

Testimonials can be made anonymously.

Yes

Are there any requirements you need in terms of accessibility? (if no please just write N/A) *

If you have any further questions or concerns, you can contact us at intersections@munsu.ca or through our Facebook page.

Applications will be reviewed on an ongoing basis, with a prioritization for those requesting size 2 cups.

Send me a copy of my responses.

Submit

Clear form

Never submit passwords through Google Forms.

reCAPTCHA

Privacy Terms

This form was created inside of Student Union. Report Abuse

Forms