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Survey about car accidents, radio, modern man, coconuts, sports and american flag.

Begin Survey

1. Do you get a flu shot every winter? Yes No

2. Do you own or drive an SUV or large truck? Yes No

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

4. Do you have health insurance? Yes No

5. Do you have any siblings? Yes No

6. Do you have children? Yes No

7. Do you listen to talk radio? Yes No

8. Are you involved in volunteerism? Yes No

9. Do you fly an American flag at home? Yes No

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

11. Will you engage in rigorous physical activity at least three times this week? Yes No

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

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

14. Have you ever been in a car accident? Yes No

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

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

17. Will you attend a professional sporting event this month? Yes No

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

19. Do you enjoy ethnic foods? Yes No

20. 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: - Oil tycoon John D. Rockefeller was the world's first billionaire. - The coconut is the largest seed in the world. - Neanderthal man had a brain capacity 100cc larger than modern man. - 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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