* 1. What is your first name?

* 2. What is your last name?

* 3. What is your email address?

* 4. What is your phone number?

5. When did you last purchase Chinese Laundry Shoes?

6. From what retailer or website did you buy your last pair of Chinese Laundry shoes?

7. Drag and drop the following in importance to you when making a shoe purchase (1 = Most Important, 4 = Least Important)

8. From what store(s) or website(s) do you most often purchase shoes?

9. How often do you purchase shoes per year?

10. I would purchase more from Chinese Laundry if:

12. Yes, please send news of exclusive promotions and new arrivals to me.