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Survey about health insurance, jelly, shopping, fried tomatoes, ronald reagan and soft drinks.

Begin Survey

1. Have you ever been in love? Yes No

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

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

4. Do you wear mittens? Yes No

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

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

7. Will you visit a hardware or home improvement store this week? Yes No

8. Do you have health insurance? Yes No

9. Do you enjoy board games? Yes No

10. Do you believe in miracles? Yes No

11. Do you suffer from seasonal allergies? Yes No

12. Do you believe in karma? Yes No

13. Do you have a savings account? Yes No

14. Do you own a motorcycle? Yes No

15. Do you drink diet soda? Yes No

16. Do you plan on visiting the public library this week? Yes No

17. Do you have any tattoos? Yes No

18. 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: - Blueberry Jelly Bellies were created especially for Ronald Reagan. - The average child will eat 1,500 peanut butter and jelly sandwiches by the he/she graduates from high school. - The human brain stops growing at the age of 18. - The tallest freestanding sculpture in the world is Chief Crazy Horse in South Dakota, USA.

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