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Survey about latte, china, health, coffee house, hiv and television.

Begin Survey

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

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

3. Do you plan on visiting the public library this week? Yes No

4. Do you ever dye your hair? Yes No

5. Do you like chocolate? Yes No

6. Have you ever cut your own hair? Yes No

7. Do you always wear your safety belt when in a car? Yes No

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

9. Do you have any food allergies? Yes No

10. Do you belong to a labor union? Yes No

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

12. Do you read the comics? Yes No

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

14. Do you have cable or satellite television? Yes No

15. 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: - Wilma Flintstone's maiden name was Wilma Slaghoopal. - Non-dairy creamer is flammable. - Only 25% of Americans eat three meals a day. - The Great Wall stretches for about 4,500 miles across North China.

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