Member Registration
Required fields are in red marked with a *.
* First Name
* Last Name
* Address
* City
* State	Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming
* Zip Code
* Email Address
* Gender	Male Female
Age
* Password
Household Income	Below $20,000 $20,000 - $50,000 $50,000 - $100,000 $100,000 - $200,000 Above $200,000
How Often Do You Work Out?	Daily Evey Other Day Bi-Weekly Weekly Occasionally
When You Work Out what you most often do?	Cardio Strength Aerobic Combination
Do you Work out at home or in a gym?	Home Gym
* What pieces of equipment do you currently have in your home?	Treadmill Elliptical Home Gym Bike Free Weights None
* What piece(s) of equipment are you looking at purchasing for your home?	Treadmill Elliptical Home Gym Bike Free Weights None
What factors are most important to you when considering purchasing a piece of equipment for your home? (check all that apply)	Price Brand Appearance Style Space Requirements Other (please indicate)
* How did you hear about True Advantage Fitness?	Website Television (please indicate station) Radio (please indicate station) Newspaper Magazine Direct Mail Customer Referral Drive By Yellow Pages Past Customer Print Publication Other (please indicate)