Event Order/ Purchase Form

Please take a look at the pictured shoes below and/or visit a website listed below.
At the bottom of the page, please use the order form to fill in the style/color/brand/size
of shoes you would like to order through payroll deduction.
You can add additional items to order or other requests in the notes section.
Feel free to call or email us with additional questions.
Please do not place orders through the websites. Orders for payroll deduction must be placed through the order form below. 
For credit card purchases, please contact us via phone or come by the store.

DANSKO

DNKO27

Professional Metallic Ink Patent

$149.95

DNKO36

Professional Mermaid Patent

$149.95

DNKO37

Professional Honey Distressed

$139.95

DNKO28

Professional Cordovan Cabrio

$139.95

DNKO29

Professional XP 2.0 Floating Hearts

$149.95

DNKO30

xp 2.0 Black Floral Tooled

$149.95

prof tropical

Professional Tropical Leaf Patent

$149.95

DNKO31

Bel Brown

$139.95

DNKO32

Bel Black

$139.95

DNKO21

Pace Black

$149.95

DNKO33

Sammy Black

$149.95

DNKO34

Sammy Taupe

$149.95

DNKO35

Sammy Tan

$149.95

CAIA BLACK

Caia Black

$139.95

CAIA TAUPE

Caia Taupe

$139.95

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BIRKENSTOCK

blk bf

Arizona Black Birkoflor

$109.95

sf taupe

Arizona Taupe Suede Soft Footbed

$144.95

oiled sf habana

Arizona Oiled Habana Soft Footbed

$144.95

mocha suede

Arizona Mocha Suede

$129.95

BRK13

Granada Oiled Tobacco Soft Footbed

$144.95

BRK7

Mayari Black Birkoflor

$109.95

gizeh braid

Gizeh Braid Black Leather

$129.95

habana mayari

Mayari Oiled Habana

$129.95

mayari white

Mayari White Birkoflor

$109.95

birkenstock bend low white

Bend Low White

$150.00

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ALEGRIA

ALG14

Classic Peace and Love

$139.95

alegria insoles

Alegria Replacement Insoles

$29.95

ALG15

Paloma Sea Turtle

$139.95

ALG16

Keli Brown Oiled

$139.95

ALG17

Kayla Dog and Butterfly

$139.95

debra wildin

Debra Wildin

$139.95

keli lucky cat

Keli Lucky Cat

$139.95

keli peace love

Keli Peace & Love

$139.95

keli doodly

Keli Doodley Doo

$139.95

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KLOGS

KLG14

Klogs Replacement Insoles

$29.95

KLG9

Moxy Electric Gator

$144.95

KLG7

Moxy Candy Skulls Patent

$144.95

KLG11

Mission Amstercats Patent

$149.95

KLG10

Moxy Cartoon Puppy

$144.95

KLG12

Moxy Black Leather

$144.95

PULSE BLK OYSTER CAMO

Pulse Black Oyster Camo

$169.95

PULSE BLK WHT SPLATTER

Pulse Black/White Splatter

$169.95

LEAP BLK BLK

Leap Black/Black

$169.95

LEAP BLUE INDIGO

Leap Blue Indigo

$169.95

naples black

Naples Black Smooth

$144.95

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UGG

class short chestnut

Classic Short Chestnut

$169.95

UG2

Classic Short Black

$169.95

class slip moss

Men’s Classic Slip-on Moss Green

$99.95

class slip chest

Men’s Classic Slip-on Chestnut

$129.95

ascot black

Ascot Black Leather

$129.95

scuffette blk gry

Scuffette Black/Grey

$94.95

scuffette chest

Scuffette Chestnut

$94.95

UG7

Scuff Black Suede

$89.95

UG8

Scuff Chestnut Suede

$89.95

UG11

Dakota Chestnut

$99.95

coquette blk

Coquette Black

$119.95

coquette chest

Coquette Chestnut

$119.95

UG13

Classic Tall Chestnut

$199.95

UG14

Classic Tall Black

$199.95

UG15

Bailey Button Triplet Grey

$219.95

UG16

Bailey Button Triplet Black

$219.95

UG17

Bailey Button Black

$179.95

UG18

Bailey Button Chestnut

$179.95

HOKA

HOK11

Women’s Bondi 8 Summer Song/Country Air

$164.95

HOK14

Men’s Hoka Ora Recovery Shoe

$89.95

HOK15

Men’s Hoka Bondi 8 PBAY

$164.95

HOK16

Men’s Bondi 8 ACTL

$164.95

HOK17

Men’s Arahi 6 Black/White

$139.95

HOK18

Women’s Bondi 8 HMLR

$164.95

HOK19

Women’s Bondi 8 BWHT

$164.95

HOK20

Women’s Clifton 8 BFPA

$139.95

HOK21

Women’s Clifton 8 CSPY

$139.95

CROCS

CRK9

Kids Alien Crocs Black

$44.95

SLATE GREY

Classic Clog Slate Grey

$49.95

CRK4

Classic Clog Black

$49.95

pink taf

Kids’ Classic Pink Taffy

$39.95

CRK10

Kids Classic Dino Clogs

$44.95

AETREX

DANIKA NAVY

Danika Navy

$139.95

carly black

Carly Black/Black

$129.95

carly burgundy

Carly Burgundy

$129.95

corey clog

Corey Clog Black

$159.95

corey clog olive

Corey Clog Olive

$159.95

TAOS

taos upward

Upward Black Multi

$149.95

court caramel

Court Caramel

$154.95

court blue

Court Blue

$154.95

rubber soul whitel

Rubber Soul White

$109.95

perfect black

Perfect Black

$139.95

perfect red

Perfect Red

$139.95

PLIM SOUL BLUE WASH

Plim Soul Blue Wash Canvas

Available in Wide Widths!

$109.95

PLIM SOUL CHARCOAL WASH

Plim Soul Black Canvas

Avalible in Wide Widths!

$109.95

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TEMPURPEDIC

CHOC THERMAN

Tempurpedic Therman Chocolate

$89.95

blk thurman

Therman Black

$89.95

laurin blk

Laurin Black

$79.95

laurin choc

Laurin Chocolate

$79.95

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JAMBU

JMBU1

Lilac in White

$109.95

JMBU2

Lilac in Red

$109.95

JMBU3

Bellerose in Red

$109.95

JMBU4

Bellerose in Tan

$109.95

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CLARKS

NATURE 5 GREY

Nature 5 Tie Dark Grey

$139.95

NATURE 5 BLACK

Nature 5 Tie Black

$139.95

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SOFFT

SHARRNELL LOW BLK

Sharnell Low Black

$189.95

sharrnell brown low

Sharnell Low Dark Brown

$189.95

ameera blk

Ameera Black

$129.95

leslie navy

Leslie Sky Blue (Navy)

$119.95

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ROCKPORT

laurel black

Laurel Woven Bootie Black

$129.95

laurel tan

Laurel Woven Bootie Tan

$129.95

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Please fill out the form below and submit. If you have any questions or notes, please leave them within the last box.

Thanks – Roxanne’s Birkenstock