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Survey about drugs, charity, snails, roller-skating, religious services and tattoos.

Begin Survey

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

2. Can you roller-skate, roller-blade, and/or ice-skate? Yes No

3. Do you read your horoscope every day? Yes No

4. Do you have any tattoos? Yes No

5. Will you visit a doctor this week? Yes No

6. Do you contribute money to any charitable organizations? Yes No

7. Are you a veteran? Yes No

8. Have you ever broken any bones? Yes No

9. Do you splash in mud puddles? Yes No

10. Will you attend religious services this week? Yes No

11. Do you have any siblings? Yes No

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

13. Do you keep an umbrella in your car? Yes No

14. Do you wear sunscreen every day? Yes No

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

16. Do you play any musical instruments? Yes No

17. Did you graduate from high school? Yes No

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

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

20. Do you drink diet soda? 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: - Barbie's full name is Barbara Millicent Roberts. - The average French citizen eats 500 snails per year. - Hailed as a wonder drug in the late nineteenth century, cocaine was outlawed in the United States in 1914. - The Eisenhower interstate system requires that one mile in every five must be straight. These straight sections are usable as airstrips in times of war or other emergencies.

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