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Survey about languages, koran, vcr, coffeine, flowers and sports.

Begin Survey

1. Will you see a play this month? Yes No

2. Have you ever broken any bones? Yes No

3. Do you own a Bible, Koran, or other religious book? Yes No

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

5. Do you plan on visiting a comedy club this month? Yes No

6. Do you have a VCR? Yes No

7. Have you ever participated in a focus group? Yes No

8. Are you left-handed? Yes No

9. Do you run the vacuum (or sweep) your floors every day? Yes No

10. Do you speak any foreign languages? Yes No

11. Will you visit a therapist or psychiatrist this week? Yes No

12. Would you consider yourself an avid sports fan? Yes No

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

14. Have you ever been the target of identity theft? Yes No

15. Do you have road rage? Yes No

16. 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: - Whoopi Golberg’s real name is Caryn Elaine Johnson. - A cup of coffee has 12 times the amount of caffeine as a cup of cocoa. - Between 25% to 33% of people sneeze when they are exposed to light. - The world’s first gas station was opened by the Gulf Refining Company on December 1, 1913, in Pittsburgh, Pennsylvania.

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