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Survey about jimi hendrix, piercings, jim morrisson, hunting, religious services and hiv.

Begin Survey

1. Do you enjoy independent films? Yes No

2. Will you attend a professional sporting event this month? Yes No

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

4. Can you whistle? Yes No

5. Do you use chewing tobacco? Yes No

6. Do you ever use a tanning bed? Yes No

7. Will you attend religious services this week? Yes No

8. Do you enjoy hunting or fishing? Yes No

9. Do you have an annual check-up or exam with your family doctor? Yes No

10. Do you enjoy classical music? Yes No

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

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

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

14. Have you ever been arrested? Yes No

15. Do you enjoy hot bubble baths? Yes No

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

17. Do you have any piercings? Yes No

18. Do you attend regular religious services? Yes No

19. Will you plant a vegetable and/or flower garden this year? Yes No

20. Do you enjoy Girl Scout cookies? 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. - A hardboiled egg will spin. An uncooked or softboiled egg will not. - 15% of Americans secretly bite their toes. - The first roller-skating rink, Belgravia Skating Rink, was opened to the public in Great Britain on August 2, 1875.

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