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Survey about glasses, george jung, health, swimming pools, ho-ho-kus and flu.

Begin Survey

1. Have you ever had a professional massage? Yes No

2. Do you have a land-line phone in your home? Yes No

3. Do you use mouthwash? Yes No

4. Did you drink coffee this morning? Yes No

5. Do you enjoy hot bubble baths? Yes No

6. Do you drink diet soda? Yes No

7. Do you get a flu shot every winter? Yes No

8. Do you enjoy classical music? Yes No

9. Do you wear glasses/contacts? Yes No

10. Do you wear mittens? Yes No

11. Do you have a swimming pool? Yes No

12. Do you have a savings account? Yes No

13. Have you ever been in a car accident? Yes No

14. Will you balance your checkbook this week? Yes No

15. Have you ever been less than honest on your resume? Yes No

16. Can you roller-skate, roller-blade, and/or ice-skate? Yes No

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

18. Do you have children? Yes No

19. Are any of your grandparents still alive? Yes No

20. Do you have road rage? Yes No

21. 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 named Mickey Mouse after Mickey Rooney, whose mother he dated for some time. - The fortune cookie was invented in 1916 by George Jung, a Los Angeles noodlemaker. - A blink lasts approximately 0.3 seconds. - 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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