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Survey about medications, television, national parks, blue jeans, poetry and writing.

Begin Survey

1. Do you plan to visit any U.S. National Parks this year? Yes No

2. Do you take any prescribed daily medications? Yes No

3. Will you balance your checkbook this week? Yes No

4. Do you use online banking? Yes No

5. Do you keep an umbrella in your car? Yes No

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

7. Do you enjoy documentary films? Yes No

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

9. Do you belong to any professional organizations? Yes No

10. Do you follow a vegetarian diet? Yes No

11. Did you graduate from high school? Yes No

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

13. Do you enjoy watching cooking shows? Yes No

14. Are you left-handed? Yes No

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

16. Do you practice yoga? Yes No

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

18. Do you know how to fly an airplane? Yes No

19. Do you enjoy reality television? Yes No

20. Do enjoy reading or writing poetry? 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: - Walt Disney, the creator of Mickey Mouse, was afraid of mice. - 50% of pizzas sold in the U.S. have pepperoni on them. - Only 1 person in 2 billion will live to be 116. - New York's Central Park is nearly twice the size of the entire country of Monaco.

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