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Request - Binder 21-22

Binder Request Form

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You must be a legal Maine resident to receive a binder. This includes students who are residents of Maine but are attending school in a different state, or legal Maine residents that are temporarily visiting out of state.
You do not qualify for a binder. Do not press submit.
This program is only open to youth in Maine.
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You, or the person receiving the binder, must be at least 14 years old to request a binder, but no older than 22.
You do not qualify because of your age. Do not hit submit.
This program is only open to youth between the ages of 14 and 22.
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(mm/dd/yyyy)
Contact Information
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First Name
Last Name
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First Name
Last Name
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Address Line 1
Address Line 2
City
State/Province
ZIP/Postal Code
Check this box if you would prefer that your package arrives without any OUT Maine information on the shipping label.
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After measuring yourself in the three different areas, please put the largest of those measurements, in inches, in the box below.
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This is the measurement from shoulder tip to shoulder tip, across the back.
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Please make sure you have measured by using the directions on our website. Compare your largest chest measurement and your shoulder measurement to the sizing chart. If your chest and shoulder measurements do not match up with the same size, choose the larger size. For Example: If your largest chest measurement is 33" (Sm) and your shoulder measurement is 17" (Med), you should choose Medium.
Binder Style Preferences
We will send you a binder in whatever color or length is available in your size. If you have a preference for color and/or length, we will check to see if it is available.
Please indicate if you prefer a short (covers chest area only) or long (covers whole torso like an undershirt) binder. The material that covers the stomach in the long binder is thinner and more stretchy than the material that covers the chest.
Please check off which colors you prefer.
Binder Color Guide

Binder Colors.png

Confirmation
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Check the box to confirm you are eligible for the program.
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Check the box to confirm you are eligible for the program.
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Check the box to confirm you are eligible for the program.