NGO and Non-Profit Interest Form

Name *

First Name

Last Name

Please select the Be Girl products you would like to distribute: *

PeriodPanty™

FlexiPad™

FitCup™ Menstrual Kit

SmartCycle®

How many total units do you expect to order? *

Less than 100

100-500

1,000-20,000

More than 20,000