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Survey about jimmy carter, cacoa, low-carb diet, pda, coupons and family.

Begin Survey

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

2. Do you have or use a PDA (Personal Digital Assistant)? Yes No

3. Will you attend a college sporting event this month? Yes No

4. Do you play any musical instruments? Yes No

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

6. Do you have health insurance? Yes No

7. Have you ever been arrested? Yes No

8. Do you follow a low-carb diet? Yes No

9. Will you send anyone a printed holiday, birthday, or anniversary card this week? Yes No

10. Do you shower at least once daily? Yes No

11. Will you visit a doctor this week? Yes No

12. Do you wear sunscreen every day? Yes No

13. Will you use a coupon for any of your purchases this week? Yes No

14. Are you a registered voter? Yes No

15. Do you keep an umbrella in your car? Yes No

16. Have you ever spent more than $100 on a pair of shoes? Yes No

17. Do you drink enough water (6 8-ounce glasses) every day? Yes No

18. Do you brush your teeth each morning? 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: - Jimmy Carter is the first U.S. President to have been born in a hospital. - A cup of coffee has 12 times the amount of caffeine as a cup of cocoa. - 80% of people over 100 years old are women. - Air conditioners completely recycle the air throughout the Empire State Building about every 10 minutes.

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