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Survey about cigarettes, shopping, grocery stores, cholesterol, basketball and flammable.

Begin Survey

1. Do you enjoy cooking or baking? Yes No

2. Are you married? Yes No

3. Do you use online banking? Yes No

4. Will you go to the grocery store this week? Yes No

5. Do you know your cholesterol level? Yes No

6. Did you drink coffee this morning? Yes No

7. Have you ever traveled by airplane? Yes No

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

9. Will you visit a therapist or psychiatrist this week? Yes No

10. Do you own a gun? Yes No

11. Do you enjoy hot bubble baths? Yes No

12. Do you have health insurance? Yes No

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

14. Do you smoke cigarettes? Yes No

15. Do you own at least one pair of blue jeans? Yes No

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

17. Do you believe in Santa Claus? Yes No

18. Do you drink diet soda? Yes No

19. Have you ever responded to a personals ad? 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: - Michael Jordan was cut from his high school basketball team his sophomore year. - Non-dairy creamer is flammable. - After the age of 35, about 1 in 27 women will give birth to twins. After 50, the chances of having twins is 1 in 9. - The first lighthouse to use electricity was the Statue of Liberty in 1886.

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