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Survey about coffee, right-handed, cars, election, safety belt and hair.

Begin Survey

1. Do you have a DVD player? Yes No

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

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

4. Do you take a daily multi-vitamin? Yes No

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

6. Do you use chewing tobacco? Yes No

7. Did you drink coffee this morning? Yes No

8. Will you balance your checkbook this week? Yes No

9. Have you ever cut your own hair? Yes No

10. Do you always wear your safety belt when in a car? Yes No

11. Do you take any prescribed daily medications? Yes No

12. Have you ever had a professional massage? Yes No

13. Will you buy a lottery ticket this week? Yes No

14. Did you vote in the last Presidential election? 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: - Theodore Roosevelt was blind in his left eye. - The average child will eat 1,500 peanut butter and jelly sandwiches by the he/she graduates from high school. - Each year, more than 2,500 left-handed people are killed by using products made for right-handed people. - The are six fictional characters that have stars on Hollywood's 'Walk of Fame'.

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