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Survey about love, veterans, chewing tobacco, honesty, snails and france.

Begin Survey

1. Do you brush your teeth after lunch? Yes No

2. Are your immunizations up-to-date? Yes No

3. Have you ever been less than honest on your income tax return? Yes No

4. Have you ever been in love? Yes No

5. Do you use chewing tobacco? Yes No

6. Do you have road rage? Yes No

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

8. Do you enjoy cat-naps? Yes No

9. Will you ride on a bus this week? Yes No

10. Do you follow a vegetarian diet? Yes No

11. Do you enjoy gambling? Yes No

12. Are you a veteran? Yes No

13. Have you ever been arrested? Yes No

14. Have you ever been less than honest on your resume? Yes No

15. Are you left-handed? Yes No

16. Do you have any houseplants? Yes No

17. Will you go to a bar or night club this week? Yes No

18. Do you read the comics? Yes No

19. 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: - Leonardo da Vinci invented scissors. - The average French citizen eats 500 snails per year. - In the year 1900,aspirin was the first drug was offered as a water-soluble tablet. - The State of Louisiana was named after the French King Louis XIV.

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