Updated 2026 Self-Referral Form

DRESS FOR SUCCESS OKLAHOMA CITY SELF-REFERRAL FORM

Providing women's professional attire, interview prep, and career coaching.
PLEASE COMPLETE AND SUBMIT THIS FORM AT YOUR EARLIEST CONVENIENCE. WE WILL CONTACT YOU DIRECTLY TO SCHEDULE AN APPOINTMENT ONCE WE VERIFY YOUR NEEDS ARE IN STOCK. WE CANNOT GUARANTEE SAME DAY APPOINTMENTS.

You must be actively job searching (unemployed or underemployed), have recently obtained a employment (job, internship, work program, etc.), or have a court appearance to receive professional attire. We do not carry casual clothing items.

All demographics collected in this referral are for data purposes only, responses do not qualify/disqualify anyone for services!

Email: oklahomacity@dressforsuccess.org

Phone: 405-606-7071

Boutique Address: 133 W. Main St., Ste. 102 Oklahoma City, OK 73102
Part One: Your Contact Information

Let us know how we can contact you!
First and Last Name*
Home Address*
City, State*
ZIP Code*
Phone*
Format: (000) 000-0000.
Email*
example@example.com
Are you currently job searching/have scheduled court date, or have recently obtained employment/internship?

Part Two: Demographics

We do not share any of your personal information. We collect demographics for research purposes only, to better understand the needs of our community.
What is your age?
Type of Transportation*
Ethnicity*
Highest Level of Education*
Marital Status*
Number of Children*
How many dependents do you have in your household? (children, grandchildren, parents, spouse, etc. that rely on you financially)
Household Income*
Do you receive financial assistance or benefits (SNAP, TANF, Medicare, Medicaid, Disability, Childcare/support, VA Benefits, etc.)*
Are you veteran?*
Have you been previously incarcerated?*
SIZES:

We will use these sizes for your styling appointment. If you're not sure, just jot down your best guess!
Top/Shirt Size:
Pant Size:
Shoe Size:
Height:
Weight:
Bra Size:
Tell us a little bit about your style! Do you like colors, neutrals, patterns, just pants or dresses, shoe preference?

Part Three: Employment Documentation

This will help us understand your clothing needs and start date.
IF YOU ARE NEEDING EMPLOYMENT ATTIRE- Please attach proof of employment (job offer, email, schedule, paystub)

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DRESS FOR SUCCESS OKLAHOMA CITY SELF-REFERRAL FORM