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Survey about cigarettes, election, smoking, health, intelligent and mouthwash.

Begin Survey

1. Do you enjoy playing video games? Yes No

2. Are your parents still married? Yes No

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

4. Do you use online banking? Yes No

5. Do you have a VCR? Yes No

6. Did you vote in the last Presidential election? Yes No

7. Do you use mouthwash? Yes No

8. Do you have any piercings? Yes No

9. Do you brush your teeth before bed each night? Yes No

10. Do you own your own business or work for yourself? Yes No

11. Can you whistle? Yes No

12. Do you think you are intelligent? Yes No

13. Do you smoke cigarettes? Yes No

14. 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: - Virgina Woolf wrote all her books while standing. - In 2003, the U.S. Government spent about $2,000,000 on potato research. - The human brain stops growing at the age of 18. - Lake Michigan is the largest lake in the United States.

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