Name* First Last Employee Number* Holiday Red Bag(s)*1 – Holiday Red Bag2 – Holiday Red Bags3 – Holiday Red Bags4 – Holiday Red Bags5 – Holiday Red Bags6 – Holiday Red Bags7 – Holiday Red Bags8 – Holiday Red Bags9 – Holiday Red Bags10 – Holiday Red BagsTotal Holday Red Bag Order $0.00 Authorization* By completing this form and entering my name and ID number, I hereby authorize Associated Grocers, Inc. to withhold from my wages the total amount entered for the Holiday Red Bag Option. Payroll deductions will take place the week of December 4th. CAPTCHAEmailThis field is for validation purposes and should be left unchanged. Δ