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Survey about diet soda, winter, writing, miracles, personal ads and homes.

Begin Survey

1. Will you be visiting any theme parks this year? Yes No

2. Do you own your home? Yes No

3. Do you drink enough water (6 8-ounce glasses) every day? Yes No

4. Do you get a flu shot every winter? Yes No

5. Do you have any siblings? Yes No

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

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

8. Are you involved in volunteerism? Yes No

9. Do you enjoy science fiction/fantasy movies? Yes No

10. Do you drink diet soda? Yes No

11. Do you own a first aid kit? Yes No

12. Do you believe in miracles? Yes No

13. Will you visit a therapist or psychiatrist this week? Yes No

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

15. Can you drive a stick shift? Yes No

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

17. Do you follow a vegetarian diet? Yes No

18. Do enjoy reading or writing poetry? 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: - James Garfield was the first U.S. president to use a telephone. - The U.S. Government spent $277,000 on pickle research in 1993. - Hailed as a wonder drug in the late nineteenth century, cocaine was outlawed in the United States in 1914. - Hawaii has the only royal palace in the United States – Iolani.

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