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Survey about broken bones, beans, cyanide, life, gamecube and bed.

Begin Survey

1. Can you drive a stick shift? Yes No

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

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

4. Do you enjoy reading non-fiction books for pleasure? Yes No

5. Do you attend regular religious services? Yes No

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

7. Have you ever been the target of identity theft? Yes No

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

9. Do you have cable or satellite television? Yes No

10. Have you ever broken any bones? Yes No

11. Do you wear cologne or perfume every day? Yes No

12. Will you consume any alcoholic beverages this weekend? 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: - Napoleon constructed his battle plans in a sandbox. - Lima beans contain cyanide. - Only 1 person in 2 billion will live to be 116. - Space Needle in Seattle, built for the 1962 Worlds Fair, is home to the Nations first Monorail, which is still in operation.

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