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Survey about michael douglas, diet soda, new jersey, 1931, alcoholic beverages and grocery stores.

Begin Survey

1. Are you currently attending college or taking adult enrichment classes? Yes No

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

3. Do you have any food allergies? Yes No

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

5. Will you go to the grocery store this week? Yes No

6. Do you believe in miracles? Yes No

7. Do you have a savings account? Yes No

8. Will you consume any alcoholic beverages this weekend? Yes No

9. Do you enjoy roller coasters? Yes No

10. Do you drink diet soda? Yes No

11. Have you ever placed a personals ad? Yes No

12. Do you have health insurance? Yes No

13. Do you know your cholesterol level? Yes No

14. 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: - Michale Keaton's original name is Michael Douglas. - After the 'Popeye' comic strip was launched in 1931, spinach consumption went up by thirty-three percent in the United States. - Children laugh about 400 times a day, while adults laugh on average only 15 times a day. - Ho-Ho-Kus, a small town in New Jersey, is the only town in the United States of America that has two dashes in its name.

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