Atwell Basic PPE Request

Basic PPE Request

Please limit shirt requests to a max of 4 shirts per employee. Any request for more than 4 shirts will be considered a speciality request and will require supervisor approval.
Name*

First NameLast Name
Date

MonthDayYear
Date
Phone Number*

Area CodePhone Number
Company

AtwellRVi
Item #1
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Quantity
Size (if applicable)
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Item #2
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Quantity
Size (if applicable)
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Item #3
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Quantity
Size (if applicable)
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Item #4
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Quantity
Size (if applicable)
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If your ordered a shirt, please choose a fabric

PolyesterCotton
Shipping Address *

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Special comments regarding order
Include size assortments or shipping deadlines
Employee PPE Responsibility
The employee is responsible for following the requirements of the PPE policy. This involves:
• Properly wearing PPE as required
• Attending training sessions
• Properly caring for, cleaning, maintaining, and inspecting PPE as required
• Following Atwell, LLC’s PPE policy and regulations
• Informing the supervisor of the need to repair or replace PPE
• Returning any FR items if leaving the company before being employed for 6 months
Note: Employees who repeatedly disregard and do not follow the PPE policy and rules will be subject to Atwell, LLC’s disciplinary policy up to and including termination.
Should be Empty: