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Survey about contact lenses, birthdays, clothes, brain, checking account and siblings.

Begin Survey

1. Do you have any siblings? Yes No

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

3. Do you play any musical instruments? Yes No

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

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

6. Do you wear glasses/contacts? Yes No

7. Have you ever been rock or mountain climbing? Yes No

8. Do you fly an American flag at home? Yes No

9. Do you own at least one pair of blue jeans? Yes No

10. Will you send anyone a printed holiday, birthday, or anniversary card this week? Yes No

11. Do you have a checking account? Yes No

12. Will you see a play this month? Yes No

13. Do you have any phobias? Yes No

14. Do you use chewing tobacco? 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: - Flamenco dancer Jose Greco took out an insurance policy through Lloyd's of London against his pants splitting during a performance. - The U.S. Government spent $277,000 on pickle research in 1993. - The human brain stops growing at the age of 18. - The first lighthouse to use electricity was the Statue of Liberty in 1886.

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