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

boho

Professional Boho Flower Patent

$144.95

dotty abstract

Professional Dotty Abstract Patent

$144.95

black box

Professional Black Box Leather

$129.95

DNKO28

Professional Cordovan Cabrio

$139.95

xp multi dot

Professional XP 2.0 Multi Dot Patent

$154.95

DNKO30

xp 2.0 Black Floral Tooled

$149.95

xp colored pencil

XP 2.0 Colored Pencil Patent

$154.95

lt hero

LT Pro Hero Patent

$144.95

lt retro flower

LT Pro Retro Flower Tooled

$144.95

DNKO21

Pace Black

$149.95

rowan black

Rowan Black

$129.95

rowan taupe

Rowan Taupe

$129.95

reece black

Reece Black

$129.95

reece stone

Reece Stone

$129.95

Reece blue

Reece Blue

$129.95

malena black

Malena Black

$129.95

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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

tokio black

Tokio Super Grip Black Leather

$154.95

habana mayari

Mayari Oiled Habana

$129.95

mayari white

Mayari White Birkoflor

$109.95

birkenstock bend low white

Bend Low White

$150.00

profi blk

Profi-Birki Black

$89.95

big buckle cognac

Arizona Big Buckle Cognac

$159.95

big buckle blac

Arizona Big Buckle Black Leather

$159.95

gizeh black

Gizeh Birko-Black

$99.95

gizeh habana

Gizeh Habana Leather

$129.95

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ALEGRIA

keli oiled black

Keli Oiled Black

$139.95

alegria insoles

Alegria Replacement Insoles

$29.95

pewter lace

Keli Pewter Lace

$139.95

ALG16

Keli Brown Oiled

$139.95

keli terrazo

Keli Terrazzo

$139.95

debra freely

Debra Freely

$139.95

debra oiled ask

Debra Oiled Ash

$139.95

paloma delicut tawny

Paloma Delicut Tawny

$139.95

paloma black

Paloma Black Nappa

$139.95

class sweet emo

Classic Sweet Emotions

$139.95

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KLOGS

KLG14

Klogs Replacement Insoles

$29.95

QUIN RHUBARB

Quinn Rhubarb

$139.95

quinn black

Quinn Black

$139.95

KLG11

Mission Amstercats Patent

$149.95

mission strawberry fields

Mission Strawberry Fields Patent

$149.95

mission black

Mission Black Smooth

$144.95

naples black

Naples Black Smooth

$144.95

wonderland naples

Naples Wonderland Patent

$149.95

naples stardust

Naples Stardust Full Grain

$149.95

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UGG

class short chestnut

Classic Short Chestnut

$179.95

UG2

Classic Short Black

$179.95

BAILEY BUTTON BLACK

Bailey Button Black

$189.95

BAILEY BUTTON CHESTNUT

Bailey Button Chestnut

$189.95

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

$109.95

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

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HOKA

HOK11

Women’s Bondi 8 Summer Song/Country Air

(Aval. in Wide)

$164.95

bondi 8 bblc

Women’s Bondi 8 Black/Black

(Aval. in Wide and in Men’s Sizes)

$164.95

HOK15

Men’s Hoka Bondi 8 Puffin’s Bill/ Amber Yellow

(Aval. in Wide)

$164.95

HOK16

Men’s Bondi 8 ACTL

(Aval. in Wide)

$164.95

HOK17

Men’s Arahi 6 Black/White

(Aval. in Wide)

$139.95

HOK18

Women’s Bondi 8 Harbor Mist/ Lunar Rock

(Aval. in Wide)

$164.95

clifton 9 bcppr

Women’s Clifton 9 Black/Copper

(Aval. in Wide)

$144.95

clifton 9 bblc

Women’s Clifton 9 Black/Black

(Aval. in Wide and in Men’s Sizes)

$144.95

clifton 9 hmbc

Men’s Clifton 9 Harbor Mist/Black

$144.95

CROCS

classic dark cherry

Classic Dark Cherry

$49.95

SLATE GREY

Classic Clog Slate Grey

$49.95

CRK4

Classic Clog Black

$49.95

pink taf

Kids’ Classic Pink Taffy

$39.95

camo green

Kids Classic Khaki Camo

$44.95

AETREX

DANIKA NAVY

Danika Navy

$139.95

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kate multi woven earth

Kate Multi Wovn

$89.95

corey clog

Corey Clog Black

$159.95

corey clog olive

Corey Clog Olive

$159.95

TAOS

gift 2 black

Gift 2 Black

$134.95

gift 2 tan

Gift 2 Tan

$134.95

the show black

The Show Black

$139.95

the show stone

The Show Stone

$139.95

Perfect Black

$139.95

taos camel

Back and Forth Camel

$174.95

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

Rubber Soul White

$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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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

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