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Survey about atoms, medications, income tax, mel blanc, lunch and blue jeans.

Begin Survey

1. Do you work outside of the home? Yes No

2. Do you have a valid passport? Yes No

3. Will you travel outside of the U.S. this year? Yes No

4. Do you take any prescribed daily medications? Yes No

5. Do you have or use a PDA (Personal Digital Assistant)? Yes No

6. Do you read your horoscope every day? Yes No

7. Do you own a gun? Yes No

8. Have you ever been less than honest on your income tax return? Yes No

9. Do you take a bagged lunch to work every day? Yes No

10. Have you ever borrowed money from a relative? Yes No

11. Do you own at least one pair of blue jeans? Yes No

12. Do you believe there is life on other planets? Yes No

13. Would you like a free video or CD-ROM with more information on owning or renting an RV? Yes No

Your Firstname:

Your Emailaddress:

Yes, I would like to join the Daily Life Survey!

Fun and Interesting facts: - Mel Blanc, the voice of Bugs Bunny, was allergic to carrots. - Chocolate does not cause acne. - Every year about 98% of atoms in the human body are replaced. - Lake Michigan is the largest lake in the United States.

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