Form

Period Supplies - Nonprofit Recipient Partner Application

The Junior League of New Orleans Period Supplies Bank is a 501(c)(3) nonprofit charitable organization that exists to help partner agencies working with families in crisis meet their need for period supplies. Period supplies are provided at no charge to approved partner agencies. The quantity of period supplies available for distribution is dependent upon donations to the Junior League of New Orleans.

Please tell us more about your organization, the social service(s) you provide and some general information about your period supply distribution program and average needs (number of menstruators you serve with tampon/pad needs, sizes needed, frequency of distribution, etc.). Recipient organizations must be nonprofits.

Organization Name:

Mailing Address:

Website Address:

Social Media Handles

Director's Name:

Contact (if different):

Contact Phone Number:

Contact Email:

Brief Description of Organization's Mission:

Is your organization a current or former partner of The Junior League of New Orleans?

Name of period supply distribution program, if different than organization name:

What neighborhoods/parishes do you serve:

Approximately how many menstruators in need of period supplies do you serve each year?

What percentage of the population that your Period Supplies Program serves lives below the federal poverty line?

What age group is your organization distributing period supplies to?

Younger than 10

10-20

21-30

31-40

41-50

51-60

60+

Do you receive period supplies from any additional sources (excluding personal donations)?

What do your clients typically need?

Liners

Sanitary Pads

Overnights (larger pad)

Tampons

(Based on availability)

How frequently do you distribute (or plan to distribute) period supplies?

Weekly

Monthly

Emergencies Only

Other

How do you reach your clients/distribute period supplies?

Period supplies are stored & distributed from our storage facility in Elmwood. Please confirm that your agency will be able to pick up period supplies from this location.

What we ask of our partners:

1) All menstruation supplies provided by the Junior League of New Orleans Period Supplies Bank are to be distributed directly to your clients without charge.

2) Acknowledgement that the Junior League of New Orleans Period Supplies Bank may reject or cancel partnership at any time due to lack of resources or any other reason.

3) Basic demographics are recorded on your part so that the Period Supplies Bank may gather, upon request, information about how many individuals and/or families were served by the diapers we provided.

4) Photos and testimonials are to be submitted at least two per year (more welcome) to: periodsupplies@jlno.org.

Please read and acknowledge:

The Junior League of New Orleans Period Supplies Bank items may not be sold, bartered or exchanged. Items received from the Period Supplies Bank may not be taken by volunteers, officers, clergy or employees for personal use. As outlined in the Internal Revenue Code Section 170(e)(3), all items you receive from The Junior League of New Orleans Period Supplies Bank must be used solely for the care of the ill, needy or minors, pursuant to your organization's charitable purpose

I have read & acknowledge the above statement

May we place your name on our website?

How did you hear about us?

By typing my name in the box below, I certify I am the Director of the organization named in this form and that the information provided her to Junior League of New Orleans is correct.

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