For Food Service and Custodial Employees

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***NOW FEATURING NEW STYLES***
Employees are eligible for two pairs of shoes per year. New employees may order both now or just one.
Please use this form to order your free pair of non-slip shoes. You can complete this form only twice per calendar year. Orders are placed on the 15th and 30th of each month, and arrive within 3-5 business days. Check the email you provided for order confirmation and info on how to pick-up your shoes.

For questions or suggestions, please call the Employee Health, Safety, and Training Department at 510-307-4658.

Email *

What is your first and last name? *

Please list a phone number that you can be reached at should there be questions regarding your order: *

What is your Employee ID Number? *

Please list your school site or office location: *

Please select your FIRST choice of shoe. "W" styles are available in Women's sizes 3-11, "M" styles are available in Men's sizes 7-16, and "U" in most men and women's sizes. *

Please select your SECOND choice of shoe. "W" styles are available in Women's sizes 3-11, "M" styles are available in Men's sizes 7-16, and "U" in most men and women's sizes. *

Please select your THIRD choice of shoe. "W" styles are available in Women's sizes 3-11, "M" styles are available in Men's sizes 7-16, and "U" in most men and women's sizes. *

What your normal shoe size? *

Is the shoe size listed in Men's or Women's sizing? *

Men's

Women's

If it is available, would you like a wide version of the shoe? *

Yes

Send me a copy of my responses.

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