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Survey about drugs, teeth, religion, coconuts, milk and intelligent.

Begin Survey

1. Do you enjoy ethnic foods? Yes No

2. Do you use online banking? Yes No

3. Do you use charge cards? Yes No

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

5. Have you ever traveled by airplane? Yes No

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

7. Do you drink milk? Yes No

8. Are you a veteran? Yes No

9. Do you always drive within the posted speed limit? Yes No

10. Do you think you are intelligent? Yes No

11. Have you ever gone sky-diving or bungee-jumping? Yes No

12. Should government employees be randomly tested for illicit drug use? Yes No

13. Do you own a Bible, Koran, or other religious book? Yes No

14. Do you brush your teeth after lunch? Yes No

15. Do you have or use a PDA (Personal Digital Assistant)? Yes No

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

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

18. 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: - More people have seen David Copperfield perform live than any other performer in the world. - The average child will eat 1,500 peanut butter and jelly sandwiches by the he/she graduates from high school. - Coconuts kill more people in the world than sharks do. Approximately 150 people are killed each year by coconuts. - The world's largest art gallery is the Winter Palace and Hermitage in St. Petersburg, Russia.

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