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Survey about family, health insurance, high school, smoking, travel and coffee substitute.

Begin Survey

1. Do you have health insurance? Yes No

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

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

4. Did you graduate from high school? Yes No

5. Do you take a bagged lunch to work every day? Yes No

6. Do you have a sit-down family dinner every night? Yes No

7. Do you think you are physically attractive? Yes No

8. Have you ever taken dance lessons? Yes No

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

10. Will you travel outside of the U.S. this year? Yes No

11. Do you wear a watch every day? Yes No

12. Do you use charge cards? Yes No

13. Do you own a motorcycle? Yes No

14. Do you plan to visit any U.S. National Parks this year? Yes No

15. Are your parents still married? Yes No

16. Do you smoke cigarettes? Yes No

17. Have you ever pilfered office supplies from work? 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: - Lyndon B. Johnson was the first president of the United States to wear contact lenses. - Dandelion root can be roasted and ground as a coffee substitute. - The average person falls asleep in seven minutes. - 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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