Date Submitted She Supply Contact Agency Contact & Title Email Address Phone Number Mailing Address Vision Mission Client Demographics by Ethnicity Client Demographics by Age Website Social Media Presence (Ex. Facebook, Instagram, etc.) County served (if multiple, breakdown) Area of Service (e.g. food pantry, domestic violence, etc.) Year of Formation Distribution Method (e.g. target client picks up during open hours like a food bank, target client receives thru shelter operations, available in open areas in operations, etc.) Overnight housing available? If Overnight housing and/or shelter – average length of stay Number of Board Members If any board members are compensated, role and compensation Where Does Your Funding Come From? Are you already receiving period products from another source? If yes, what are your additional needs? Products & Quantity Requested How many women or teenage girls does your agency see a week? Any other factors that should be considered? Please submit form with most recent 990 form to [email protected]. Applications without financial documents will not be considered.
