Uniform Requisition Form
Complete this form for your annual uniform order. Select items that you need for the year and submit the form. Orders will automatically notify Lieutenant Dirks in Logistics.
First and Last Name
*
Work Email
*
Credential
EMT
AEMT
Paramedic
CCEMT-P
Title
List your rank or title for uniform embroidery
Hat
Please Select
Richardson 112 Trucker Hat
Richardson 115 Low Profile Trucker Hat (Great option for smaller heads)
Toboggan/Beanie
Please Select
Navy with Leather Patch Front
EMS Badge (Only if you do not have one)
Please Select
New Employee Issued
Replacement
T Shirts
Select size and Quantity
EMS T-Shirts (Select QTY in next Question)
Please Select
XS
S
M
L
XL
XXL
3XL
EMS T-Shirt QTY
Please Select
1
2
3
Polos
Select size and Quantity
Polo Size (Female and Male Available)
Please Select
Female XS Reg
Female S Reg
Female M Reg
Female L Reg
Female L Tall
Female XL
Female XXL
Male XS Reg
Male S Reg
Male M Reg
Male L Reg
Male L Tall
Male XL Reg
Male XL Tall
Male XXL Reg
Male 3XL Reg
Male 3XL Tall
Male 4XL Reg
Male 4XL Tall
EMS Polo QTY
Please Select
1
2
3
Pants
Select STYLE, size and Quantity
Pants Select Style. Make sure you choose your size in the next question.
Please Select
5.11 Men's EMS Pants
5.11 Women's EMS Pants
First Tactical Men's EMS Pants
First Tactical Women's EMS Pants
Pants Size (Female and Male Available)
Please Select
28x30
28x32
28x34
28x36
30x30
30x32
30x34
30x36
32x30
32x32
32x34
32x36
34x30
34x32
34x34
34x36
36x30
36x32
36x34
36x36
38x30
38x32
38x34
38x36
40x30
40x32
40x34
40x36
42x30
42x32
42x34
42x36
44x30
44x32
44x34
44x36
0 Reg
0 Tall
2 Reg
2 Tall
4 Reg
4 Tall
6 Reg
6 Tall
8 Reg
8 Tall
10 Reg
10 Tall
12 Reg
12 Tall
14 Reg
14 Tall
16 Reg
16 Tall
18 Reg
18 Tall
20 Reg
20 Tall
22 Reg
22 Tall
24 Reg
24 Tall
Pants Quantity - Blue
Please Select
1
2
3
Pants Quantity - Khaki (Admin/CP only)
Please Select
1
2
3
Blauer EMS Shirts
Select STYLE, size and Quantity
Blauer Polyester Select Style. Make sure to select size in next question.
Please Select
Short Sleeve Men's Blue
Short Sleeve Men's White
Short Sleeve Women's Blue
Short Sleeve Women's White
Long Sleeve Men's White
Long Sleeve Women's White
Blauer Polyester Size Options (Female and Male Available. Men will need to select sleeve length for long sleeve shirt)
Please Select
XS Reg Men's Short Sleeve
S Reg Men's Short Sleeve
S Tall Men's Short Sleeve
M Reg Men's Short Sleeve
M Tall Men's Short Sleeve
L Reg Men's Short Sleeve
L Tall Men's Short Sleeve
XL Reg Men's Short Sleeve
XL Tall Men's Short Sleeve
XXL Reg Men's Short Sleeve
XXL Tall Men's Short Sleeve
3XL Reg Men's Short Sleeve
3XL Tall Men's Short Sleeve
4XL Reg Men's Short Sleeve
4XL Tall Men's Short Sleeve
30 Reg Women's Short Sleeve/Long Sleeve
32 Reg Women's Short Sleeve/Long Sleeve
34 Reg Women's Short Sleeve/Long Sleeve
36 Reg Women's Short Sleeve/Long Sleeve
38 Reg Women's Short Sleeve/Long Sleeve
40 Reg Women's Short Sleeve/Long Sleeve
42 Reg Women's Short Sleeve/Long Sleeve
44 Reg Women's Short Sleeve/Long Sleeve
46 Reg Women's Short Sleeve/Long Sleeve
48 Reg Women's Short Sleeve/Long Sleeve
50 Reg Women's Short Sleeve/Long Sleeve
Men's Long Sleeve 14 (Select sleeve length in next question)
Men's Long Sleeve 14.5 (Select sleeve length in next question)
Men's Long Sleeve 15 (Select sleeve length in next question)
Men's Long Sleeve 15.5 (Select sleeve length in next question)
Men's Long Sleeve 16 (Select sleeve length in next question)
Men's Long Sleeve 16.5 (Select sleeve length in next question)
Men's Long Sleeve 17 (Select sleeve length in next question)
Men's Long Sleeve 17.5 (Select sleeve length in next question)
Men's Long Sleeve 18 (Select sleeve length in next question)
Men's Long Sleeve 18.5 (Select sleeve length in next question)
Men's Long Sleeve 19 (Select sleeve length in next question)
Sleeve Length (Only select if ordering a men's long sleeve Blauer)
Please Select
31
33
35
37
Blauer Shirt Quantity
Please Select
1
2
3
Job Shirt/Pullover
Select STYLE size and Quantity
Style
Please Select
First Tactical
5.11
Select Size (Female and Male Available)
Please Select
Female XS Reg
Female S Reg
Female M Reg
Female L Reg
Female L Tall
Female XL
Female XXL
Male XS Reg
Male S Reg
Male M Reg
Male L Reg
Male L Tall
Male XL Reg
Male XL Tall
Male XXL Reg
Male 3XL Reg
Male 3XL Tall
Male 4XL Reg
Male 4XL Tall
Raincoat
Select STYLE, size and Quantity
Raincoat
Please Select
Men's High Viz Tactix System FULL TIME ONLY!
Women's High Viz Tactix System FULL TIME ONLY!
Men's Navy Parka System ADMIN ONLY!
Women's Navy Parka System ADMIN ONLY!
Part Time Rain Coat by Liberty
Raincoat Size
Please Select
XS
S
M
L
XL
2XL
3XL Men's ONLY!
4XL Men's ONLY
Notes
Submit
Should be Empty: