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Survey about bungee-jumping, health, volunteers, artery, satellite and chewing tobacco.

Begin Survey

1. Are you involved in volunteerism? Yes No

2. Have you ever gone sky-diving or bungee-jumping? Yes No

3. Do you own a motorcycle? Yes No

4. Do you smoke cigarettes? Yes No

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

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

7. Do you use chewing tobacco? Yes No

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

9. Have you ever been tested for HIV? Yes No

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

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

12. Do you play any musical instruments? Yes No

13. Do you ever dye your hair? Yes No

14. Have you ever been in love? Yes No

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

16. 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: - Alfred Hitchcock didn't have a belly button. - Approximately 3 billion pizzas are sold in the U.S. each year. - The aorta, the largest artery in the body, is almost the diameter of a garden hose. - The Statue of Liberty is one hundred fifty one feet and one inch tall. Her index finger is eight feet long, her fingernails are thirteen inches long, and her nose is four and a half feet long.

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