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Survey about coffee, health, books, vegetarian diet, religion and piercings.

Begin Survey

1. Will you ride on a bus this week? Yes No

2. Do you have a DVD player? Yes No

3. Did you drink coffee this morning? Yes No

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

5. Do you like peanut butter and jelly sandwiches? Yes No

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

7. Do you watch the evening news? Yes No

8. Do you have any piercings? Yes No

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

10. Do you belong to a credit union? Yes No

11. Do you own a pair of fuzzy bunny slippers? Yes No

12. Do you have or use a cellular phone? Yes No

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

14. Do you follow a vegetarian diet? Yes No

15. 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: - Ralph Lauren's original name is Ralph Lifshitz. - Strawberries are a member of the rose family. - Half of all Americans over the age of 55 have no teeth. - The Boston University Bridge (on Commonwealth Avenue, Boston, Massachusetts) is the only place in the world where a boat can sail under a train driving under a car driving under an airplane.

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