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Survey about health insurance, shopping, trips, hotels, take-out and drugs.

Begin Survey

1. Do you ever download music from the Internet? Yes No

2. Do you enjoy ethnic foods? Yes No

3. Do you own a motorcycle? Yes No

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

5. Do you have health insurance? Yes No

6. Do you plan on taking a trip by airplane this week? Yes No

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

8. Are you a registered voter? Yes No

9. Do you enjoy spicy foods? Yes No

10. Will you be staying at a hotel this week? Yes No

11. Do you play any musical instruments? Yes No

12. Have you graduated from (or finished) college? Yes No

13. Will you buy plants or flowers from a florist this week? Yes No

14. Will you order take-out or delivery food from a restaurant this week? Yes No

15. Do you use charge cards? Yes No

16. Do you have Internet access at home? Yes No

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

18. Will you be visiting any theme parks this year? 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: - Jimi Hendrix, Janis Joplin, and Jim Morrison were all 27 years old when they died. - Peanuts are one of the ingredients in dynamite. - Hailed as a wonder drug in the late nineteenth century, cocaine was outlawed in the United States in 1914. - The State of Nevada's name comes from the Spanish meaning 'snow-capped'.

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