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Survey about jail, dinner, belly button, ebay, sneeze and airplanes.

Begin Survey

1. Do you practice yoga? Yes No

2. Do you drink diet soda? Yes No

3. Have you ever purchased or sold anything on eBay? Yes No

4. Do you have a savings account? Yes No

5. Do you watch the evening news? Yes No

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

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

8. Do you own a first aid kit? Yes No

9. Do you have a swimming pool? Yes No

10. Have you ever been arrested? Yes No

11. Do you play any musical instruments? Yes No

12. Do you have any phobias? Yes No

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

14. Do you have any pets? Yes No

15. Have you ever traveled by airplane? Yes No

16. Do you smoke cigarettes? Yes No

17. Have you ever gone sky-diving or bungee-jumping? Yes No

18. Are you satisfied in your current employment? Yes No

19. Do you take any prescribed daily medications? Yes No

20. 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: - Alfred Hitchcock didn't have a belly button. - Chocolate does not cause acne. - A sneeze travels at 100 miles per hour. - Central Park (in New York City) has 125 drinking fountains.

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