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Survey about charlie chaplin, psychiatrists, beauty salons, employees, traffic tickets and coffee.

Begin Survey

1. Do you own a boat, camper, or other recreational vehicle? Yes No

2. Will you visit a therapist or psychiatrist this week? Yes No

3. Have you eaten fast food this week? Yes No

4. Should government employees be randomly tested for illicit drug use? Yes No

5. Have you ever broken any bones? Yes No

6. Do you know how to fly an airplane? Yes No

7. Do you suffer from seasonal allergies? Yes No

8. Do you attend regular religious services? Yes No

9. Will you travel outside of the U.S. this year? Yes No

10. Have you graduated from (or finished) college? Yes No

11. Do you enjoy independent films? Yes No

12. Have you ever gotten a traffic ticket? Yes No

13. Will you visit a beauty salon this week? Yes No

14. Will you go see a new-release movie at a theater this week? Yes No

15. Do you have a VCR? 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: - Charlie Chaplin once won third prize in a Charlie Chaplin look alike contest. - The world's rarest coffee, called Kopi Luwak, costs $300 a pound. - More people have a phobia of frogs than rats. - The world's largest art gallery is the Winter Palace and Hermitage in St. Petersburg, Russia.

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