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Survey about cigarettes, luggage, cpr, vegetarian diet, pasta and fast food.

Begin Survey

1. Will you see a play this month? Yes No

2. Do you plan on performing any community service this week? Yes No

3. Do you know CPR? Yes No

4. Have you ever been in a car accident? Yes No

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

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

7. Do you have any tattoos? Yes No

8. Do you have a valid passport? Yes No

9. Have you ever been rock or mountain climbing? Yes No

10. Do you own a matching set of luggage? Yes No

11. Do you have an annual check-up or exam with your family doctor? Yes No

12. Do you smoke cigarettes? Yes No

13. Do you have a checking account? Yes No

14. Are any of your grandparents still alive? Yes No

15. Should the ban on new lines of stem cells for research in the U.S. be lifted? Yes No

16. Do you follow a vegetarian diet? Yes No

17. Do you own a Bible, Koran, or other religious book? Yes No

18. Do you have a retirement investment account (401k, IRA, etc.)? Yes No

19. 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 named Mickey Mouse after Mickey Rooney, whose mother he dated for some time. - The average American eats approximately 20 pounds of pasta each year. - Hailed as a wonder drug in the late nineteenth century, cocaine was outlawed in the United States in 1914. - The Library of Congress, located in Washington D.C., is the largest library in the world.

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