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Survey about bubble baths, pizza, michale keaton, contact lenses, sleep and rats.

Begin Survey

1. Will you use a coupon for any of your purchases this week? Yes No

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

3. Do you wear glasses/contacts? Yes No

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

5. Do you have a retirement investment account (401k, IRA, etc.)? Yes No

6. Do you own a motorcycle? Yes No

7. Do you suffer from seasonal allergies? Yes No

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

9. Do you run the vacuum (or sweep) your floors every day? Yes No

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

11. Are you involved in volunteerism? Yes No

12. Do you enjoy hot bubble baths? Yes No

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

14. 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: - Michale Keaton's original name is Michael Douglas. - 50% of pizzas sold in the U.S. have pepperoni on them. - More children are allergic to cockroaches than cats - Built in 1763, Touro Synagogue in Newport, Rhode Island, is the oldest surviving synagogue in North America.

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