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Survey about fire eater, homes, psychiatrists, acne, light and shoes.

Begin Survey

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

2. Do you believe in karma? Yes No

3. Have you ever broken any bones? Yes No

4. Do you own your home? Yes No

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

6. Do you contribute money to any charitable organizations? Yes No

7. Do you suffer from seasonal allergies? Yes No

8. Have you ever spent more than $100 on a pair of shoes? Yes No

9. Are you left-handed? Yes No

10. Are you married? Yes No

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

12. Do you have any food allergies? Yes No

13. 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: - Pierce Brosnan once worked in the circus as a fire eater. - Chocolate does not cause acne. - Between 25% to 33% of people sneeze when they are exposed to light. - The State of Louisiana was named after the French King Louis XIV.

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