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Survey about digital camera, names, medications, antioxidants, jail and health.

Begin Survey

1. Have you ever been arrested? Yes No

2. Do you believe in miracles? Yes No

3. Do you wear mittens? Yes No

4. Do you own a console video game system (Xbox, Playstation 2, GameCube, etc.)? Yes No

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

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

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

8. Do you take a bagged lunch to work every day? Yes No

9. Do you ever download movies from the Internet? Yes No

10. Do you believe in love at first sight? Yes No

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

12. Do you own or use a digital camera? Yes No

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

14. Will you go to a concert this week? 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: - Whoopi Golberg’s real name is Caryn Elaine Johnson. - Blueberries have more antioxidants than any other fruit or vegetables. - Only 25% of Americans eat three meals a day. - The Golden Gate Bridge was first opened in 1937.

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