Human Resource Supply Order

Select month for supply order

For tracking purposes please provide which month you are placing the order for.

Name

First Name

Last Name

Branch Name

Email Address

Shipping Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

HR Supplies

Leave blank or enter 0 (zero) if not ordering an item

Oral-Tox Drug Kits

Enter Quantity (25 kits per box)

Drug Test Lab Material

Enter Quantity

Change (rapid! PayCard)

Enter Quantity (25 per box)

Name Tags

Enter Quantity (25 name tags per pack)

Current Inventory

Please list current inventory: Drug kits, name tags and rapid cards.

Additional instructions, Comments or Information