Please enable JavaScript in your browser to complete this form.Please submit your information and the HR Department will contact you when your order has been received.Larger sizes are a special order and pricing will be provided when ordered.Badge Number *Name *FirstLastJob Title *Location *Amarillo Town ClubArborsCorporatePark CentralPhone *Email *Sizing & Price *POLO SHIRT / Small - $19.00POLO SHIRT / Medium - $19.00POLO SHIRT / Large - $19.00POLO SHIRT / XL - $19.00POLO SHIRT / XXL - $21.00POLO SHIRT / XXXL - $24.00POLO SHIRT / XXXXL - Special Order - Pricing UnavailablePOLO SHIRT / XXXXXL - Special Order - Pricing UnavailableSex *MALEFEMALEQuanity *Signature *Clear SignaturePayroll Deduction *By CHECKING this box, I agree to the BCS Terms of Service, and understand my purchase will be deducted from BCS PayrollThis authorizes the deduction of $____________ (The “Deductible amount”) from my wages to be paid by Baptist Community Services (“BCS”) and any of its affiliates. This amount will be deducted evenly over (1,2, or 3) pay periods. This is to begin with the pay period commencing next pay period. I also authorize any remaining balance of the deductible amount, any indebtedness or any other amount owed by me to BCS or any of its affiliates to be deducted in full from my final pay upon termination of my employment. PURPOSE FOR DEDUCTION: BCS Polo Logo Shirts. Should I terminate my employment or should my employment be terminated by BCS prior to repayment of the deductible amount, said amount in full shall become immediately due and payable. BCS can take any means necessary and pursue any remedies available in order to recoup the remaining portion of the deductible amount. Further, BCS shall be entitled in addition to recoup from its costs of collecting the deductible amount (including, but not limited to, any court costs and reasonable attorney’s fees).Current Payroll DeductionsSpend $0.00 to $20.00 - Amount Deducted from 1 Check | Spend $21.00 to $40.00 - Amount Deducted from 2 Checks | Spend $41.00 and Up - Amount Deducted from 3 Checks Captcha * = PhoneSubmit Share this:TwitterFacebookLike this:Like Loading...