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

dan prof spray paint patent

Professional Spray Paint Patent

$149.95

dansko lt pro indigo

LT Pro Indigo

$129.95

danskoltproteal

LT Pro Teal

$129.95

DNKO4

Professional Cordovan Cabrio

$129.95

dansko prof tan tumbled-1

Professional Tan Tumbled

$139.95

DNKO6

xp 2.0 Black Floral Tooled

$149.95

Professional Fragment Patent

$149.95

dansko kane blue

Kane Blue

$79.95

dansko kane black

Kane Black

$79.95

dansko pace black

Pace Black

$149.95

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BIRKENSTOCK

BRK1

Arizona Black Birkoflor

$99.95

BRK2

Arizona Taupe Suede Soft Footbed

$139.95

BRK3

Arizona Oiled Habana Soft Footbed

$139.95

BRK4

Arizona Mocha Suede

$125.00

BRK5

Granada Oiled Tobacco Soft Footbed

$139.95

BRK6

Granada Black Birkoflor

$99.95

BRK7

Mayari Black Birkoflor

$99.95

BRK8

Mayari Oiled Habana

$125.00

BRK9

Mayari White Birkoflor

$99.95

birkenstock bend low white

Bend Low White

$150.00

bir boston sf oil tob

Boston Tobacco Oiled Leather, Soft Footbed

$149.95

birkenstock boston habana

Boston Habana Oiled Leather, Soft Footbed

$149.95

ALEGRIA

ALG1

Debra Black Leather

$139.95

alg keli cherry

Keli Pro Cherry Patent

$139.95

ALG3

Paloma Black Nappa

$139.95

alegria keli leopard

Keli Leopard

$139.95

ALG5

Kayla Black Nappa

$139.95

alegria debra wildin

Debra Wildin

$139.95

KLOGS

KLG1

Naples Black Leather

$139.95

klogs naples blotter patent

Naples Blotter Patent

$139.95

klogs moxy candy skulls

Moxy Candy Skulls Patent

$139.95

KLG4

Mission Black Leather

$139.95

klogs springfield black

Springfield Black

$79.95

KLG6

Moxy Black Leather

$139.95

UGG

UG1

Classic Short Chestnut

$169.95

UG2

Classic Short Black

$169.95

UG3

Classic Mini Black

$149.95

UG4

Classic Mini Chestnut

$149.95

UG5

Ascot Black Leather

$129.95

ugg fluff yeah red

Fluff Yeah Red Ribbon

$99.95

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

UG7

Scuff Black Suede

$89.95

UG8

Scuff Chestnut Suede

$89.95

UG9

Coquette Black

$119.95

UG10

Coquette Chestnut

$119.95

UG11

Dakota Chestnut

$99.95

UG12

Dakota Espresso

$99.95

HOKA

hoka vlifton 8 outerpace

Clifton 8 Outerspace

$139.95

hoka bondi sr black

Bondi SR in Black/Black

$169.95

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CROCS

Crcos classic green

Classic Clog Green

$49.95

CRK2

Classic Clog Red

$49.95

clogs classic black

Classic Clog Black

$49.95

CRK3

Bistro Clog Black

$59.95

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SALTWATER SANDALS

SLT1

Original Tan

$39.95

SLT2

Original White

$39.95

SLT3

Original Black

$39.95

SLT4

Surfer Pink

$39.95

SLT5

Surfer Tan

$39.95

SLT6

Surfer White

$39.95

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