PayPal Processing Service
Payments are processed using Paypal. A Paypal account is NOT required to submitt payment.
Visa, Mastercard, Discover, American Express, and Paypal Accepted.
Customer E-Mail

*Customer E-mail  
Important: Enter a valid e-mail address. Receipts will be sent to this address.
Student Information

*Student`s Name  
*Students School  

Shoe Sizing & Style
Please enter the sizing information from your Students fitting form in the fields below.

Your order is limited to ONE pair per form entry. If you require more than one pair please complete an additional order form.
For bulk orders please contact (330) 733-4131.

*Shoe Style  
*Shoe Color  
*Gender  
*Width   Medium is standard width.

Sub-Total:  
Tax (OH 6.75%):  
Grand Total:  
Contact/Billing Information

*First Name:   Same name as on your card
Middle Initial:  
*Last Name:  
*Address Line 1:   Where your statement is mailed
Address Line 2:   Apt. or Suite No.
*City:  
*State:  
*Zip Code:  
Phone:  
Order Number:  


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