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Survey about espresso, musical instruments, cappuccino, peach family, money and bungee-jumping.

Begin Survey

1. Are you married? Yes No

2. Do you have health insurance? Yes No

3. Do you have any houseplants? Yes No

4. Have you ever been tested for HIV? Yes No

5. Are any of your grandparents still alive? Yes No

6. Do you plan on visiting a mall this week? Yes No

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

8. Are you satisfied in your current employment? Yes No

9. Do you believe in miracles? Yes No

10. Do you know your cholesterol level? Yes No

11. Do you enjoy spicy foods? Yes No

12. Do you play any musical instruments? Yes No

13. Do you practice yoga? Yes No

14. Do you listen to the radio in the car? Yes No

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

16. Will you buy an espresso drink (cappuccino, latte etc.) from a coffee house this week? Yes No

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

18. Do you smoke cigarettes? Yes No

19. Have you ever responded to a personals ad? Yes No

20. Are your immunizations up-to-date? 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: - Whoopi Golberg’s real name is Caryn Elaine Johnson. - Almonds are a member of the peach family. - Right-handed people live, on average, nine years longer than left-handed people. - There are 10 towns/cities named Hollywood in the United States.

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