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Survey about cigarettes, luck, smoking, health, hands and fortune cookies.

Begin Survey

1. Have you ever won the lottery? Yes No

2. Will you order take-out or delivery food from a restaurant this week? Yes No

3. Do you get a flu shot every winter? Yes No

4. Do you listen to the radio in the car? Yes No

5. Do you believe in miracles? Yes No

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

7. Do you smoke cigarettes? Yes No

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

9. Do you enjoy documentary films? Yes No

10. Have you ever been arrested? Yes No

11. Are you left-handed? Yes No

12. Do you wear cologne or perfume every day? Yes No

13. Will you visit a doctor this week? Yes No

14. Do you suffer from seasonal allergies? Yes No

15. Have you ever broken any bones? Yes No

16. Do you get between 7 to 10 hours of sleep each night? Yes No

17. Do you own or use a digital camera? Yes No

18. Do you drink milk? Yes No

19. Do you plan on visiting a mall this week? 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: - Cleopatra wasn't Egyptian; she was Greek. - The fortune cookie was invented in 1916 by George Jung, a Los Angeles noodlemaker. - One in 500 humans has one blue eye and one brown eye. - Buckingham Palace has over six hundred rooms.

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