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Survey about food, headache pain, cigarettes, food additives, credit unions and phobias.

Begin Survey

1. Do you belong to a credit union? Yes No

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

3. Do you smoke cigarettes? Yes No

4. Have you ever cut your own hair? Yes No

5. Have you ever broken any bones? Yes No

6. Can you whistle? Yes No

7. Do you own a gun? Yes No

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

9. Do you have any phobias? Yes No

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

11. Will you visit a doctor this week? Yes No

12. Have you ever eaten fried green tomatoes? Yes No

13. Will you go to the grocery store this week? Yes No

14. Do you plan to visit the zoo this year? Yes No

15. Are your parents still married? Yes No

16. 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: - Walt Disney, the creator of Mickey Mouse, was afraid of mice. - Headache pain can be reduced by eating 20 tart cherries. - The average American consumes 9 pounds of food additives every year. - Air conditioners completely recycle the air throughout the Empire State Building about every 10 minutes.

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