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Survey about evening news, blue jeans, broken bones, movies, travel and wilma flintstones.

Begin Survey

1. Do you have health insurance? Yes No

2. Do you have a checking account? Yes No

3. Do you own at least one pair of blue jeans? Yes No

4. Do you wear glasses/contacts? Yes No

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

6. Do you speak any foreign languages? Yes No

7. Have you ever broken any bones? Yes No

8. Do you know your cholesterol level? Yes No

9. Have you eaten fast food this week? Yes No

10. Do you have road rage? Yes No

11. Do you enjoy Girl Scout cookies? Yes No

12. Are you a registered voter? Yes No

13. Do you watch the evening news? Yes No

14. Will you be staying at a hotel this week? Yes No

15. Have you ever purchased or sold anything on eBay? Yes No

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

17. Do you enjoy science fiction/fantasy movies? Yes No

18. Do you have a valid passport? Yes No

19. Do you believe in karma? Yes No

20. Do you use mouthwash? 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: - Wilma Flintstone's maiden name was Wilma Slaghoopal. - The average French citizen eats 500 snails per year. - In the year 1900,aspirin was the first drug was offered as a water-soluble tablet. - Ho-Ho-Kus, a small town in New Jersey, is the only town in the United States of America that has two dashes in its name.

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