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Survey about dishes, traffic tickets, birth, glasses, contact lenses and twins.

Begin Survey

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

2. Will you go to a bar or night club this week? Yes No

3. Are you satisfied in your current employment? Yes No

4. Have you ever traced your family tree? Yes No

5. Do you attend regular religious services? Yes No

6. Do you plan on visiting the public library this week? Yes No

7. Do you enjoy card games? Yes No

8. Do you enjoy board games? Yes No

9. Do you smoke cigarettes? Yes No

10. Do you eat lunch every day? Yes No

11. Do you wear glasses/contacts? Yes No

12. Do you use a dishwasher to do your dishes? Yes No

13. Do you enjoy cat-naps? Yes No

14. Do you think professional athletes should be regularly screened for illicit drug use? Yes No

15. Do you have an annual check-up or exam with your family doctor? Yes No

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

17. 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: - Sonny and Cher originally called themselves Cleo and Caesar. - Lima beans contain cyanide. - After the age of 35, about 1 in 27 women will give birth to twins. After 50, the chances of having twins is 1 in 9. - There are 10 towns/cities named Hollywood in the United States.

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