Facility Information: *

Order/Change Type: *

For transfers-allow 1-2 weeks for delivery location change

Associate Information:

Associate Name: *

Associate Name (as it will appear on emblem): *

No Nicknames, Standard = First Name Only ~ Supervisor = First and Last Name, Leader Emblem

Male
Female

Uniform Information: *

Garment Selection:

Shirts Only
Pants Only
Both

Shirt Size: *

Shirt Type: *

Quantity: # of Short Sleeve *

(Please note if using a combination it must equal quantity ordered)

# of Long Sleeve *

Pant Size-Waist: *

Length: *

Special Instructions:

Associate Signature/Authorization:

I authorize Shape Corporation to deduct uniform rental charges from my paycheck. I do understand that the uniforms are the property of WM Uniform. I also understand that all uniforms must be returned to Shape Corporation upon termination of employment (or if uniforms are no longer provided) and that I will be charged for any uniforms that are not returned or are damaged.

Date *

Associate Signature *

Please Type Name

Message

Associate Information:

Associate Signature/Authorization:

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