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Survey about dvds, earthquakes, zip codes, doctor, drugs and phobias.

Begin Survey

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

2. Do you work outside of the home? Yes No

3. Do you ever download music from the Internet? Yes No

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

5. Have you ever been in a tornado, earthquake, or other natural disaster? Yes No

6. Do you always wear your safety belt when in a car? Yes No

7. Do you watch Saturday morning cartoons? Yes No

8. Have you made your will? Yes No

9. Do you have any phobias? Yes No

10. Will you rent a DVD or video this weekend? Yes No

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

12. Have you graduated from (or finished) college? Yes No

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

14. Do you ever use a tanning bed? Yes No

15. Do you have cable or satellite television? Yes No

16. 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: - 20252 is Smokey the Bear's own zip code. - Dandelion root can be roasted and ground as a coffee substitute. - You are more likely to get attacked by a cow than a shark. - In Washington D.C., no building may be built taller than the Washington Monument.

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