JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
100 Suits Suiting Appointment Request
Welcome. Please fill out the form below to schedule an in-office appointment to receive professional attire. An 100 Suits outreach team member will contact you to confirm your appointment.
Sign in to Google
to save your progress.
Learn more
* Indicates required question
Email
*
Your email
Full Name ( First & Last)
*
Your answer
Email Address
*
Your answer
Are you a new or existing client?
*
Choose
New client
Existing Client
How did you hear about 100 Suits
*
Choose
referral: Word of Mouth
another organization/ agency
social media
case manager
Which organization were you referred by:
*
Choose
FedCap
Dept. of Corrections (Rikers Island)
Dept. Of Corrections (State)
Dept. Of Parole
ACS
York College
WeCare
NPower
Please provide your suit size. (if known)
*
Your answer
Please provide the following measurements if you don't know your Suit Size. (if known)
Height:
Weight:
Waist Measurement:
Neck measurement:
Jacket Size:
Please list in order
*
Your answer
Please check all that apply:
The purpose of your suit request is related to the following:
*
Interview Attire
Court attire
Never owned
Employment Attire
Required
I would be interested in receiving the following additional services:
*
Housing
Gainful Employment
Community Engagement ( volunteering/ mentoring)
Mentorship
Therapeutic services
Legal Assistance
Public Assistance: SNAP
Required
Please provide the best phone number to reach you. We will only call in case of an emergency cancellation. Please note your appointment will be sent via EMAIL and will need to be confirmed via EMAIL by you at least 24 hours before your appointment time.
*
Your answer
Questions or Concerns
*
Your answer
Submit
Page 1 of 1
Clear form
Never submit passwords through Google Forms.
This form was created inside of 100 Suits.
Report Abuse
Forms
