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Survey about dinner, charlie chaplin, download, mud puddles, tattoos and internet access.

Begin Survey

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

2. Do you have any tattoos? Yes No

3. Do you splash in mud puddles? Yes No

4. Will you use a coupon for any of your purchases this week? Yes No

5. Do you have road rage? Yes No

6. Do you like chocolate? Yes No

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

8. Do you use mouthwash? Yes No

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

10. Have you ever gotten a traffic ticket? Yes No

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

12. Do you brush your teeth each morning? Yes No

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

14. Are you involved in volunteerism? Yes No

15. Do you have a VCR? Yes No

16. Do you enjoy documentary films? Yes No

17. Do you shower at least once daily? Yes No

18. Will you go to a concert this week? Yes No

19. Do you have a sit-down family dinner every night? Yes No

20. 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: - Charlie Chaplin once won third prize in a Charlie Chaplin look alike contest. - Nutmeg is extremely poisonous if injected intravenously. - The liquid inside young coconuts can be used as a substitute for blood plasma. - Built in 1763, Touro Synagogue in Newport, Rhode Island, is the oldest surviving synagogue in North America.

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