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Survey about food, cacoa, coffee, roller coasters, passports and allergy.

Begin Survey

1. Do you have a valid passport? Yes No

2. Do you own a console video game system (Xbox, Playstation 2, GameCube, etc.)? Yes No

3. Do you have any siblings? Yes No

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

5. Do you have any food allergies? Yes No

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

7. Are you married? Yes No

8. Would you consider yourself an avid sports fan? Yes No

9. Do you follow a vegetarian diet? Yes No

10. Do you enjoy roller coasters? Yes No

11. Do you enjoy gambling? Yes No

12. Do you drink milk? Yes No

13. Have you ever been rock or mountain climbing? Yes No

14. 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. - A cup of coffee has 12 times the amount of caffeine as a cup of cocoa. - 15% of Americans secretly bite their toes. - The only place in the US where four states intersect at a single point is called Four Corners. The four states are Utah, New Mexico, Colorado, and Arizona.

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