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Survey about floors, smoking, cigarettes, mittens, vacuum and income tax.

Begin Survey

1. Will you order take-out or delivery food from a restaurant this week? Yes No

2. Will you visit a casino this week? Yes No

3. Do you always wear your safety belt when in a car? Yes No

4. Do you have cable or satellite television? Yes No

5. Have you ever placed a personals ad? Yes No

6. Do you wear mittens? Yes No

7. Do you smoke cigarettes? Yes No

8. Do you enjoy cooking or baking? Yes No

9. Do you run the vacuum (or sweep) your floors every day? Yes No

10. Do you know your cholesterol level? Yes No

11. Do you plan on visiting the public library this week? Yes No

12. Have you ever been less than honest on your income tax return? Yes No

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

14. Will you engage in rigorous physical activity at least three times this week? Yes No

15. Are you currently attending college or taking adult enrichment classes? Yes No

16. Do you have any houseplants? Yes No

17. Do you have a retirement investment account (401k, IRA, etc.)? Yes No

18. Do you feel Americans file too many frivolous lawsuits? Yes No

19. Do you take a daily multi-vitamin? Yes No

20. 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: - Oil tycoon John D. Rockefeller was the world's first billionaire. - Seaweed is used to thicken ice cream. - Between 25% to 33% of people sneeze when they are exposed to light. - 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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