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Survey about contact lenses, pillow, teeth, trips, 27 and vegetarian diet.

Begin Survey

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

2. Do you plan on taking a trip by airplane this week? Yes No

3. Do you brush your teeth before bed each night? Yes No

4. Do you wear sunscreen every day? Yes No

5. Do you sleep with a pillow at night? Yes No

6. Do you enjoy independent films? Yes No

7. Do you plan on visiting a mall this week? Yes No

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

9. Will you plant a vegetable and/or flower garden this year? Yes No

10. Do you splash in mud puddles? Yes No

11. Do you enjoy reading non-fiction books for pleasure? Yes No

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

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

14. Do you wear glasses/contacts? Yes No

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

16. Do you follow a vegetarian diet? Yes No

17. Should government employees be randomly tested for illicit drug use? Yes No

18. Do you have Internet access at home? Yes No

19. 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: - Jimi Hendrix, Janis Joplin, and Jim Morrison were all 27 years old when they died. - The U.S. Government spent $277,000 on pickle research in 1993. - Every year about 98% of atoms in the human body are replaced. - The Golden Gate Bridge was first opened in 1937.

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