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Survey about falling coconuts, vegetarian diet, chewing tobacco, jelly, morning and airplanes.

Begin Survey

1. Do you follow a vegetarian diet? Yes No

2. Do you suffer from seasonal allergies? Yes No

3. Do you enjoy cat-naps? Yes No

4. Do you play any musical instruments? Yes No

5. Do you use chewing tobacco? Yes No

6. Do you fly an American flag at home? Yes No

7. Do you have or use a cellular phone? Yes No

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

9. Do you enjoy watching cooking shows? Yes No

10. Do you plan on taking a trip by airplane this week? Yes No

11. Have you ever pilfered office supplies from work? Yes No

12. Do you have Internet access at home? Yes No

13. Do you own your home? Yes No

14. Do you listen to talk radio? Yes No

15. Do you like peanut butter and jelly sandwiches? Yes No

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

17. Do you brush your teeth each morning? 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: - Basketball great Wilt Chamberlain never fouled out of a game. - The average American eats approximately 60 hot dogs per year. - Club Direct, a travel insurance company in Britain, provides insurance plans for protection from falling coconuts. - Buckingham Palace has over six hundred rooms.

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