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Survey about health insurance, intelligent, spicy food, lightening, jim morrisson and books.

Begin Survey

1. Have you ever participated in a focus group? Yes No

2. Do you have health insurance? Yes No

3. Do you own at least one pair of blue jeans? Yes No

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

5. Do you enjoy television police/crime dramas? Yes No

6. Do you own a Bible, Koran, or other religious book? Yes No

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

8. Do you have any tattoos? Yes No

9. Do you think you are intelligent? Yes No

10. Have you ever been in a tornado, earthquake, or other natural disaster? Yes No

11. Do you have a sit-down family dinner every night? Yes No

12. Do you own a gun? Yes No

13. Do you have any houseplants? Yes No

14. Do enjoy reading or writing poetry? Yes No

15. Do you have any pets? Yes No

16. Do you play any musical instruments? Yes No

17. Do you brush your teeth before bed each night? Yes No

18. Do you enjoy documentary films? Yes No

19. Have you eaten fast food this week? Yes No

20. Do you enjoy spicy foods? 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: - Jimi Hendrix, Janis Joplin, and Jim Morrison were all 27 years old when they died. - The fortune cookie was invented in 1916 by George Jung, a Los Angeles noodlemaker. - Men are 6 times more likely to be struck by lightning than women. - The Sears Tower in Chicago has its own zip code.

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