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Survey about glasses, health, pepperoni, yoga, jackie kennedy and siblings.

Begin Survey

1. Have you ever responded to a personals ad? Yes No

2. Will you consume any alcoholic beverages this weekend? Yes No

3. Will you rent a DVD or video this weekend? Yes No

4. Do you have any siblings? Yes No

5. Do you practice yoga? Yes No

6. Will you see a play this month? Yes No

7. Have you ever broken any bones? Yes No

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

9. Do you wear glasses/contacts? Yes No

10. Do you believe there is life on other planets? Yes No

11. Are you a registered voter? Yes No

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

13. Do you like peanut butter and jelly sandwiches? Yes No

14. Do you enjoy card games? Yes No

15. Do you enjoy gambling? Yes No

16. Are your immunizations up-to-date? Yes No

17. Are you married? Yes No

18. Do you use mouthwash? Yes No

19. 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: - Jackie Kennedy Onassis was secretly a chain smoker. - 50% of pizzas sold in the U.S. have pepperoni on them. - Most dreams last only 5 to 20 minutes. - The tallest building west of the Mississippi River is the Stratosphere Hotel and Casino in Las Vegas, Nevada.

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