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Survey about coffee house, broken bones, new jersey, latte, doctors and ho-ho-kus.

Begin Survey

1. Do you use charge cards? Yes No

2. Will you visit a hardware or home improvement store this week? Yes No

3. Do you have children? Yes No

4. Do you ever download music from the Internet? Yes No

5. Will you consume any alcoholic beverages this weekend? Yes No

6. Do you work outside of the home? Yes No

7. Will you buy an espresso drink (cappuccino, latte etc.) from a coffee house this week? Yes No

8. Do you know your cholesterol level? Yes No

9. Will you travel outside of the U.S. this year? Yes No

10. Have you ever broken any bones? Yes No

11. Have you ever traced your family tree? Yes No

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

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

14. Do you read the comics? Yes No

15. Do you contribute money to any charitable organizations? Yes No

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

17. 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: - John F. Kennedy is the only U.S president to win a Pulitzer Prize. - The candy bar 'Baby Ruth' was named after the daughter of U.S. President Grover Cleveland in 1921. - During a typical human life span, the human heart will beat approximately 2.5 billion times. - Ho-Ho-Kus, a small town in New Jersey, is the only town in the United States of America that has two dashes in its name.

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