Step 1 of 9 11% Name* First Last Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAntigua and BarbudaArgentinaArmeniaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia and HerzegovinaBotswanaBrazilBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCosta RicaCôte d'IvoireCroatiaCubaCuraçaoCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEast TimorEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFaroe IslandsFijiFinlandFranceFrench PolynesiaGabonGambiaGeorgiaGermanyGhanaGreeceGreenlandGrenadaGuamGuatemalaGuineaGuinea-BissauGuyanaHaitiHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJordanKazakhstanKenyaKiribatiNorth KoreaSouth KoreaKosovoKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMauritaniaMauritiusMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew ZealandNicaraguaNigerNigeriaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaSaint Kitts and NevisSaint LuciaSaint Vincent and the GrenadinesSaint MartinSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSpainSri LankaSudanSudan, SouthSurinameSwazilandSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTogoTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVatican CityVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.YemenZambiaZimbabwe Country Phone*Email* Age*Please enter a value between 1 and 110.Gender*GenderMaleFemaleHeight*format: 5'10"Weight*lbs.Current Athletic Shoe Size* Which model best describes the wear pattern on your current athletic shoes? Use your tape measure or ruler to measure the length of each foot. Place bare foot up against a wall and measure using a ruler or other measuring device.Left Foot(ex. 9.5")Right Foot(ex. 9.5") Use your tape measure or ruler to measure the width of each foot. Place bare foot up against a wall and measure using a ruler or other measuring device.Left Foot(ex. 3.5")Right Foot(ex. 3.5") Record a short (10 sec) video of yourself walking on your floor or on a treadmill. Please perform this barefoot and position camera behind you. File Select which activities you will be using these shoes for. You can select more than one. Walking Running Gym How would you classify your running foot strike?HeelMidfootForefootWhich box best descibes your exercise mileage per week.>1010-3030-5050+Any current foot conditions or foot discomfort? None Achilles Tendonitis Athlete's Foot Blisters Bunions Hammer Toes Heel Spurs Metatarsalgia Plantar Fasciitis Shin Splints How much do you usually spend on athletic shoes?>$100$101-$125$126-$150$151+ Which color scheme appeals to you best? Core Neutral Bright Feminine Which brand and model do you currently wear? Adidas Altra Asics Brooks Hoka Mizuno New Balance Nike Saucony On Brand Other BrandModel? This iframe contains the logic required to handle Ajax powered Gravity Forms.