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Survey about chicago, glasses, dance lessons, homes, health and sneeze.

Begin Survey

1. Do you have or use an MP3 player? Yes No

2. Do you have road rage? Yes No

3. Do you have any piercings? Yes No

4. Do you use mouthwash? Yes No

5. Do you have or use a cellular phone? Yes No

6. Do you have any pets? Yes No

7. Do you eat breakfast every morning? Yes No

8. Do you own your home? Yes No

9. Do you wear glasses/contacts? Yes No

10. Do you keep an umbrella in your car? Yes No

11. Do enjoy reading or writing poetry? Yes No

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

13. Do you brush your teeth each morning? Yes No

14. Have you ever taken dance lessons? Yes No

15. Do you enjoy card games? Yes No

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

17. Can you roller-skate, roller-blade, and/or ice-skate? Yes No

18. 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: - Walt Disney, the creator of Mickey Mouse, was afraid of mice. - The average American eats approximately 60 hot dogs per year. - Between 25% to 33% of people sneeze when they are exposed to light. - The Sears Tower in Chicago has its own zip code.

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