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Survey about chocolate, documentary films, health, physical activity, lemons and homes.

Begin Survey

1. Do you take a daily multi-vitamin? Yes No

2. Do you give your children a daily multi-vitamin? Yes No

3. Do you shower at least once daily? Yes No

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

5. Do you use chewing tobacco? Yes No

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

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

8. Have you ever pilfered office supplies from work? Yes No

9. Would you consider yourself to be in good overall health? Yes No

10. Do you eat lunch every day? Yes No

11. Do you like chocolate? Yes No

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

13. Do you enjoy documentary films? Yes No

14. Do your children attend public schools? Yes No

15. Do you own your home? Yes No

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

17. Will you consume any alcoholic beverages this weekend? Yes No

18. Do you play any musical instruments? Yes No

19. Do you enjoy roller coasters? 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: - Charlie Chaplin once won third prize in a Charlie Chaplin look alike contest. - Lemons contain more sugar than strawberries. - Both carrots and ketchup were once considered to have medicinal value. - The names of the two stone lions in front of the New York Public Library are Patience and Fortitude, named by then-mayor Fiorello LaGuardia.

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