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Survey about documentary films, chain smoker, newspapers, trips, frogs and airplanes.

Begin Survey

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

2. Do you wear glasses/contacts? Yes No

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

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

5. Do you have health insurance? Yes No

6. Have you ever been in a car accident? Yes No

7. Do you watch the evening news? Yes No

8. Have you ever broken any bones? Yes No

9. Do you plan to visit the zoo this year? Yes No

10. Do you enjoy documentary films? Yes No

11. Do you subscribe to your local newspaper? Yes No

12. Do you run the vacuum (or sweep) your floors every day? Yes No

13. Would you consider yourself to be in good overall health? Yes No

14. Have you ever borrowed money from a relative? Yes No

15. Do you own at least one pair of blue jeans? Yes No

16. Do you have a swimming pool? Yes No

17. Did you graduate from high school? Yes No

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

19. Do you belong to a labor union? Yes No

20. Have you eaten fast food this week? Yes No

21. 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: - Jackie Kennedy Onassis was secretly a chain smoker. - Headache pain can be reduced by eating 20 tart cherries. - More people have a phobia of frogs than rats. - The Great Wall stretches for about 4,500 miles across North China.

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