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Request for Product Donation
Company Name
*
Title
First Name
*
Last Name
*
Address 1
*
Address 2
City
*
State
*
Alabama
Alaska
Arizona
Arkansas
California
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Connecticut
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District of Columbia
Florida
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Armed Forces Europe, the Middle East, an
Armed Forces Pacific
Alberta
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Ontario
Prince Edward Island
Quebec
Saskatchewan
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Zip
*
Email
*
Phone
Phone Type
Work
Home
Mobile
Other
What are you interested in receiving? Check all that apply.
New and gently used bras
Pads and liners
Tampons
I understand that I Support the Girls cannot pay for shipping at this time, and that if my organization receives a donation we will be responsible for the shipping costs.
Yes
What is the mission of your organization?
*
How many girls and/or women do you serve on a monthly basis? (an estimate or range is acceptable)
*
Is there anything else you would like us to know?
How did you learn of I Support the Girls?
Social Media
Web Search
Friend/Family
Other
Yes, I would like to receive communications from Support the Girls by email.
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