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Survey about cappuccino, trains, take-out, peanut butter, piercings and latin.

Begin Survey

1. Have you ever broken any bones? Yes No

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

3. Will you order take-out or delivery food from a restaurant this week? Yes No

4. Do you have a swimming pool? Yes No

5. Do you wear mittens? Yes No

6. Do you always wear your safety belt when in a car? Yes No

7. Do you enjoy hunting or fishing? Yes No

8. Are your immunizations up-to-date? Yes No

9. Do you like peanut butter and jelly sandwiches? Yes No

10. Do you read your horoscope every day? Yes No

11. Will you buy a lottery ticket this week? Yes No

12. Will you take any train or subway rides this week? Yes No

13. Will you be visiting any theme parks this year? Yes No

14. Do you listen to talk radio? Yes No

15. Will you buy an espresso drink (cappuccino, latte etc.) from a coffee house this week? Yes No

16. Do you have any piercings? Yes No

17. 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: - Leonardo da Vinci was dyslexic. - The onion is named after a Latin word meaning large pearl. - Only 1 person in 2 billion will live to be 116. - There are 10 towns/cities named Hollywood in the United States.

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