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Survey about charity, health insurance, children, smoking, cholesterol and tattoos.

Begin Survey

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

2. Do you plan on visiting a mall this week? Yes No

3. Should the ban on new lines of stem cells for research in the U.S. be lifted? Yes No

4. Do you smoke cigarettes? Yes No

5. Do you enjoy television police/crime dramas? Yes No

6. Do you have health insurance? Yes No

7. Do you think you are physically attractive? Yes No

8. Do you use chewing tobacco? Yes No

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

10. Do you subscribe to your local newspaper? Yes No

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

12. Do you know your cholesterol level? Yes No

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

14. Do you contribute money to any charitable organizations? Yes No

15. Do you have any tattoos? Yes No

16. Do you have children? Yes No

17. Do you follow a vegetarian diet? Yes No

18. Do you have any houseplants? Yes No

19. 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: - Ralph Lauren's original name is Ralph Lifshitz. - Coca-Cola was the first soft drink to be consumed in outer space. - One quarter of the human brain is used to control the eyes. - The very peak of the Washington Monument is not stone, but a 100-ounce solid aluminum pyramid, constructed as part of the monument's lightning protection system.

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