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Survey about coffeine, cacoa, organizations, lottery tickets, books and safety belt.

Begin Survey

1. Have you ever been the target of identity theft? Yes No

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

3. Do you enjoy spicy foods? Yes No

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

5. Have you ever been in a car accident? Yes No

6. Are you married? Yes No

7. Do you enjoy reality television? Yes No

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

9. Do you enjoy classical music? Yes No

10. Have you ever placed a personals ad? Yes No

11. Do you watch the evening news? Yes No

12. Have you ever eaten fried green tomatoes? Yes No

13. Are you satisfied in your current employment? Yes No

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

15. Do you use mouthwash? Yes No

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

17. Do your children attend public schools? Yes No

18. Do you belong to any professional organizations? Yes No

19. Will you take any train or subway rides this week? Yes No

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

21. 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: - Betsy Ross was born with a fully formed set of teeth. - A cup of coffee has 12 times the amount of caffeine as a cup of cocoa. - The little lump of flesh just forward of the ear canal, right next to the temple, is called a tragus. - The Golden Gate Bridge was first opened in 1937.

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