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Survey about beauty salons, night clubs, radio, writing, road trips and passports.

Begin Survey

1. Do enjoy reading or writing poetry? Yes No

2. Do you smoke cigarettes? Yes No

3. Will you be taking any road trips this week (over 50 miles)? Yes No

4. Do you use chewing tobacco? Yes No

5. Have you ever gotten a traffic ticket? Yes No

6. Do you get a flu shot every winter? Yes No

7. Do you ever download music from the Internet? Yes No

8. Do you enjoy roller coasters? Yes No

9. Do you have a valid passport? Yes No

10. Do you ever use a tanning bed? Yes No

11. Will you plant a vegetable and/or flower garden this year? Yes No

12. Do you have Internet access at home? Yes No

13. Do you enjoy playing video games? Yes No

14. Do you listen to talk radio? Yes No

15. Will you go to a bar or night club this week? Yes No

16. Do you follow a vegetarian diet? Yes No

17. Do you own a console video game system (Xbox, Playstation 2, GameCube, etc.)? Yes No

18. Will you visit a beauty salon this week? Yes No

19. 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: - Albert Einstein was offered the presidency of Israel in 1952 (he declined). - Seaweed is used to thicken ice cream. - The United States produces more tobacco than it does wheat. - The Sears Tower in Chicago has its own zip code.

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