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Survey about classical music, wheat, spoil, videos, baking and wills.

Begin Survey

1. Do you wear glasses/contacts? Yes No

2. Are your immunizations up-to-date? Yes No

3. Have you ever broken any bones? Yes No

4. Do you have a valid passport? Yes No

5. Do you plan to visit the zoo this year? Yes No

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

7. Have you ever been less than honest on your income tax return? Yes No

8. Do you have any piercings? Yes No

9. Do you enjoy cooking or baking? Yes No

10. Do you ever download movies from the Internet? Yes No

11. Have you made your will? Yes No

12. Do you enjoy classical music? Yes No

13. Will you rent a DVD or video this weekend? Yes No

14. Have you ever borrowed money from a relative? Yes No

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

16. 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: - Blueberry Jelly Bellies were created especially for Ronald Reagan. - Honey is the only food that will not spoil. - The United States produces more tobacco than it does wheat. - Built in 1763, Touro Synagogue in Newport, Rhode Island, is the oldest surviving synagogue in North America.

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