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Survey about hiv, airplanes, veterans, adults, trips and children.

Begin Survey

1. Do you enjoy roller coasters? Yes No

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

3. Do you own or drive an SUV or large truck? Yes No

4. Have you ever been tested for HIV? Yes No

5. Do you have children? Yes No

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

7. Do you follow a vegetarian diet? Yes No

8. Did you vote in the last Presidential election? Yes No

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

10. Do you drink milk? Yes No

11. Do you think you are intelligent? Yes No

12. Do you splash in mud puddles? Yes No

13. Can you whistle? Yes No

14. Are you a veteran? Yes No

15. Do you take a daily multi-vitamin? Yes No

16. Do you work outside of the home? Yes No

17. 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: - James Garfield was the first U.S. president to use a telephone. - Lima beans contain cyanide. - Children laugh about 400 times a day, while adults laugh on average only 15 times a day. - The are six fictional characters that have stars on Hollywood's 'Walk of Fame'.

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