Shoes for Crews Online Order Form

Shoes for Crews Online Order Form

Los Poblanos will provide a stipend of $50 towards one pair of shoes ordered through SFC as an LP employee every year. Employees are responsible for the balance beyond the stipend through payroll deduction. The employee will have the option of spreading the balance over up to 3 paychecks. Styles can be viewed at https://www.shoesforcrews.com
Name*

First NameLast Name
Email*
example@example.com
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Department
Shoes for Crews Style Name*
Shoes for Crews Style Number*
Shoe Size*
Yes
Have you already received a pair of shoes from this program this year?*
Payroll Deduction Options:

Employees will have the opportunity to participate in the SFC payroll deduction program at 100% of the cost at no limit. The only requirement is that all current balances have been paid.
Price:*
Los Poblanos will pay $ of the cost of my shoes, which means my balance is $ * .
I hereby request that the remaining $ balance be paid by Payroll Deduction (to be collected when shoes are received). I request the balance be deducted over paychecks.
Please Note:

Style restrictions exist. Please refer to your department’s dress code policy and the list of approved styles per department to make your selection. Styles can be viewed at https://www.shoesforcrews.com
Date

MonthDayYear
Date
Should be Empty:

Payroll Deduction Options: