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Survey about latte, candy, chocolate, coffee house, tootsie rolls and trips.

Begin Survey

1. Are you left-handed? Yes No

2. Have you ever traveled by airplane? Yes No

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

4. Will you buy an espresso drink (cappuccino, latte etc.) from a coffee house this week? Yes No

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

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

7. Do you enjoy independent films? Yes No

8. Will you engage in rigorous physical activity at least three times this week? Yes No

9. Have you ever been in a car accident? Yes No

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

11. Do you enjoy ethnic foods? Yes No

12. Do you plan on visiting a mall this week? Yes No

13. Do you use online banking? Yes No

14. Do you enjoy spicy foods? Yes No

15. Do you own at least one pair of blue jeans? Yes No

16. Do you use mouthwash? Yes No

17. Do you always drive within the posted speed limit? Yes No

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

19. Do you like chocolate? Yes No

20. Are your immunizations up-to-date? 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: - Ralph Lauren's original name is Ralph Lifshitz. - Tootsie Rolls were the first wrapped penny candy in America. - A blink lasts approximately 0.3 seconds. - The Boston University Bridge (on Commonwealth Avenue, Boston, Massachusetts) is the only place in the world where a boat can sail under a train driving under a car driving under an airplane.

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