CCA Uniform Order Form

Complete this form on your browser, print and mail or fax to Postal Uniforms Direct!� You may also print this order and complete manually to be mailed or faxed.

This form is NOT secure, as it is not intended to be transmitted via the Internet.��

Postal Uniforms Direct

9800 Industrial Blvd
Lenexa� KS� 66215

(913) 764-4488

E-mail

Office Hours:

8:00am-5:00pm CST
Monday-Friday

Order Toll Free during office hours:� 888.682.8889

or Fax Toll Free 877.227.0167

�

Name
Years of Service Carrier Y/N

Employment Station Ship order: HomeWork

Employment City State Zip

Home Address City

Address (contd.) State
Zip

E-mail Home Phone

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Measurements:

Height:

Weight:

Waist

Inseam

Item#

QTY

DESCRIPTION

Size

Price Ea.
�
Total

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Grand Total:
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��FREE SHIPPING�

If you will be exceeding your uniform allowance, please complete the following:

Visa Mastercard Discover

Enter your Credit Card Number in the space provided below.

Exp:�

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Name		Years of Service			Carrier Y/N
Employment Station		Ship order:	HomeWork
Employment City		State		Zip
Home Address		City
Address (contd.)		State		Zip
E-mail		Home Phone
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Item#	QTY	DESCRIPTION	Size	Price Ea.	�	Total
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Grand Total:					�

CCA Uniform Order Form

��FREE SHIPPING�

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