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Survey about driving, phobias, therapists, central park, night and jail.

Begin Survey

1. Do you wear sandals/flip-flops in the summer? Yes No

2. Can you drive a stick shift? Yes No

3. Do you have any phobias? Yes No

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

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

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

7. Will you engage in rigorous physical activity at least three times this week? Yes No

8. Will you visit a beauty salon this week? Yes No

9. Do you have a savings account? Yes No

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

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

12. Will you ride on a bus this week? Yes No

13. Are your parents still married? Yes No

14. Do you eat breakfast every morning? Yes No

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

16. Have you ever been arrested? Yes No

17. Have you ever been less than honest on your income tax return? Yes No

18. Do you have any camping trips planned for this summer? Yes No

19. Do you brush your teeth before bed each 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: - Jackie Kennedy Onassis was secretly a chain smoker. - In 2003, the U.S. Government spent about $2,000,000 on potato research. - More people have a phobia of frogs than rats. - Central Park (in New York City) has 125 drinking fountains.

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