Employee Order Form
Employee Name:
Component:
*
Choose One
Admin
Support Services
Community Waiver Hope
Community Waiver Prescott
Community Waiver Arkadelphia
Residential Hope
Residential Prescott
Residential Arkadelphia
Rainbow Industries
ROC Enterprises
Rainbow Junction
Prescott Recycling Center
Bright Beginnings
Item Wanted:
*
Shirt A
Shirt B
Shirt C
Other, explain
Only items that are available will be ordered, any item not being offered will NOT be ordered.
If you selected other, please explain:
Color:
*
Blue
Maroon
Green
Purple
Other Color, explain below
Only colors currently being offered will be ordered. Color will vary depending on item availability.
Size:
*
Small
Medium
Large
X-Large
2XL
3XL
4XL, if available
5XL, if available
Item Wanted:
*
Shirt A
Shirt B
Shirt C
Other, explain
N/A
Only items that are available will be ordered, any item not being offered will NOT be ordered.
If you selected other, please explain:
Color:
*
Blue
Maroon
Green
Purple
Other Color, explain below
Only colors currently being offered will be ordered. Color will vary depending on item availability.
Size:
*
Small
Medium
Large
X-Large
2XL
3XL
4XL, if available
5XL, if available
N/A
Item Wanted:
*
Shirt A
Shirt B
Shirt C
Other, explain
N/A
Only items that are available will be ordered, any item not being offered will NOT be ordered.
If you selected other, please explain:
Color:
*
Blue
Maroon
Green
Purple
Other Color, explain below
Only colors currently being offered will be ordered. Color will vary depending on item availability.
Size:
*
Small
Medium
Large
X-Large
2XL
3XL
4XL, if available
5XL, if available
N/A
Item Wanted:
*
Shirt A
Shirt B
Shirt C
Other, explain
N/A
Only items that are available will be ordered, any item not being offered will NOT be ordered.
If you selected other, please explain:
Color:
*
Blue
Maroon
Green
Purple
Other Color, explain below
Only colors currently being offered will be ordered. Color will vary depending on item availability.
Size:
*
Small
Medium
Large
X-Large
2XL
3XL
4XL, if available
5XL, if available
N/A
Item Wanted:
*
Vest
Jacket A Crossland Microfleece
Jacket B High Sierra Lightweight
Shirt A
Shirt B
Shirt C
Other, explain
N/A
Only items that are available will be ordered, any item not being offered will NOT be ordered.
If you selected other, please explain:
Color:
*
Blue
Maroon
Green
Purple
Other Color, explain below
Only colors currently being offered will be ordered. Color will vary depending on item availability.
Size:
*
Small
Medium
Large
X-Large
2XL
3XL
4XL, if available
5XL, if available
N/A
Phone
*
Payment Method
*
Cash, bring to 500 South Main, or mail to PO Box 1540 Hope
PayPal, go back to ROC Shop page
CashApp: $rocpnc
Credit/Debit cards
Checks are not accepted.
Submit
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