2026 Moon Pie Fund Request

Moon Pie Fund

Welcome to our menstrual hygiene and sexual health fund! There is no age limit for requests and while you do not need to be Native American/Indigenous to apply, we will prioritize Native American and Indigenous applicants. All information is protected. Please give us about a week to fulfill your order! If you have any questions or concerns, please text Cookie Lorenzo: 505-403-5058!
Name

First NameLast Name
What is the best way to contact you?
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Email
example: ILoveIWR@iwrising.org
Social media handle (ONLY for direct messages, if that is your preference!)
Social Media Platform
Mailing Address (we will send with discreet packaging!)

Street Address or PO Box

Street Address Line 2

CityState

Zip Code
(If you're in the Albuquerque area or in surrounding Pueblos, we may be able to deliver!) Please select if you would like to arrange delivery.
How old are you?
This helps us know which age group is needing our assistance the most!
What tribe are you from or what is your ethnicity?
Anyone may apply but Native & Indigenous folks will be prioritized.
Menstrual Hygiene Products
PLEASE SELECT YOUR TOP FOUR (4) PRODUCTS TO BE GIVEN PRIORITY WHEN PACKING YOUR MOON PIE KIT.
While we would love to have unlimited resources to help unlimited clients, we are not always able to fill each request due to supply shortages.
Priority 1
Items are listed alphabetically
Priority 2
Items are listed alphabetically
Priority 3
Items are listed alphabetically
Priority 4
Items are listed alphabetically
Please select if you are in a situation where you need more than the 4 priority items
Additional Item Requests will be packaged based on product availablity.
In a world and time filled with uncertainty, IWR's mission remains true in our efforts to provide equitable access to health resources and education.
While we would love to have unlimited resources to help unlimited clients, we are not always able to fill each request due to supply shortages.
ADDITIONAL REQUEST 1
Items are listed alphabetically
ADDITIONAL REQUEST 2
Items are listed alphabetically
ADDITIONAL REQUEST 3
Items are listed alphabetically
ADDITIONAL REQUEST 4
Items are listed alphabetically
If you selected MENSTRUAL CUP, what size do you need?
If you selected MENSTRUAL DISC, what size do you need?
If you selected PADS (DISPOSABLE), what flow(s) do you need?
If you selected PADS (REUSABLE), what flow(s) do you need?
If you selected PERIOD UNDERWEAR, what size & style (flow) would you like?
If you selected TAMPONS, what flow(s) do you need?
Contraception

Commonly known as "birth control" - contraception not only helps as an additional protection against pregnancy, but is also an important part of healthy and safe intercourse discussions as an additional protection from sexually transmitted infections (STIs). This section also includes lubrication for comfort, and test strips for pregnancy detection (pregnancy tests).
ALL Moon Pie Kits will come with a "Snag Bag" which includes:
External Latex Condoms (3-4)
Lubrication (2-3 individual packets)
* There is an option to request extra condoms in addition to the Snag Bag *
IF YOU DO NOT WISH TO RECEIVE A "SNAG BAG" YOU MUST CHECK THE BOX BELOW
NO "SNAG BAG"
PLEASE SELECT YOUR TOP FOUR (4) PRODUCTS TO BE GIVEN PRIORITY WHEN PACKING YOUR MOON PIE KIT.
While we would love to have unlimited resources to help unlimited clients, we are not always able to fill each request due to supply shortages.
Priority 1
Items are listed alphabetically
Priority 2
Items are listed alphabetically
Priority 3
Items are listed alphabetically
Priority 4
Items are listed alphabetically
Please select if you are in a situation where you need more than the 4 priority items
Additional Item Requests will be packaged based on product availablity.
In a world and time filled with uncertainty, IWR's mission remains true in our efforts to provide equitable access to health resources and education.
While we would love to have unlimited resources to help unlimited clients, we are not always able to fill each request due to supply shortages.
ADDITIONAL REQUEST 1
Items are listed alphabetically
ADDITIONAL REQUEST 2
Items are listed alphabetically
ADDITIONAL REQUEST 3
Items are listed alphabetically
ADDITIONAL REQUEST 4
Items are listed alphabetically
Clothing

This section includes clothing items for developing bodies, as well as gender-affirming clothing items
Clothing Option 1
Clothing Option 2
If you selected TRAINING BRA, what size(s) do you need? (YOUTH)
If you selected CHEST BINDER, what size do you need?
If you selected OTHER GENDER AFFIRMING CLOTHING/ITEMS, please describe what you need and what size.
If you have a link, that would be helpful, too!
Education

This section includes educational materials, such as books on various reproductive health topics. Part of making informed decisions means being educated on what options are available.
Books on Puberty
Books on Sexual Health
Is there anything you'd like for us to know?
Please provide some feedback on the variety of products offered in this form?
If you would like to stay involved with Indigenous Women Rising
by volunteering or interning,
please fill out this form by CLICKING HERE!
Should be Empty:

Moon Pie Fund

Menstrual Hygiene Products

Contraception

Clothing

Education