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Survey about broken bones, pillow, family, sleep, shopping and chocolate.

Begin Survey

1. Do you like chocolate? Yes No

2. Do you have a valid passport? Yes No

3. Do you have a sit-down family dinner every night? Yes No

4. Do you have any siblings? Yes No

5. Do you sleep with a pillow at night? Yes No

6. Do you get between 7 to 10 hours of sleep each night? Yes No

7. Will you go to the grocery store this week? Yes No

8. Do you wear glasses/contacts? Yes No

9. Will you visit a hardware or home improvement store this week? Yes No

10. Do you own a gun? Yes No

11. Do you ever dye your hair? Yes No

12. Have you ever been in love? Yes No

13. Have you ever broken any bones? Yes No

14. Do you enjoy spicy foods? Yes No

15. Are you involved in volunteerism? Yes No

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

17. Do you own a first aid kit? Yes No

18. 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: - Barbie's full name is Barbara Millicent Roberts. - Americans eat more than 22 pounds of tomatoes every year. - English sailors were referred to as "limeys" because sailors added lime juice to their diet to combat scurvy. - There are 10 towns/cities named Hollywood in the United States.

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