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Survey about lifshitz, flu, children, breakfast, contact lenses and life.

Begin Survey

1. Will you be taking any road trips this week (over 50 miles)? Yes No

2. Have you ever gotten a traffic ticket? Yes No

3. Do you eat breakfast every morning? Yes No

4. Have you ever been in love? Yes No

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

6. Do you sing in the shower? Yes No

7. Do you have a savings account? Yes No

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

9. Do you smoke cigarettes? Yes No

10. Will you be staying at a hotel this week? Yes No

11. Have you ever broken any bones? Yes No

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

13. Have you ever gone sky-diving or bungee-jumping? Yes No

14. Have you ever pilfered office supplies from work? Yes No

15. Will you take any train or subway rides this week? Yes No

16. Do you own a gun? Yes No

17. Do you play any musical instruments? Yes No

18. Do you believe there is life on other planets? Yes No

19. Do you wear glasses/contacts? 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: - Ralph Lauren's original name is Ralph Lifshitz. - The average French citizen eats 500 snails per year. - Children laugh about 400 times a day, while adults laugh on average only 15 times a day. - The Hollywood sign was first erected in 1923. It was first erected as 'Hollywoodland.'

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