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Survey about money, phobias, relatives, insurance, capitol building and tattoos.

Begin Survey

1. Do you have any phobias? Yes No

2. Are you a veteran? Yes No

3. Will you visit a casino this week? Yes No

4. Do you sleep with a pillow at night? Yes No

5. Do you have any tattoos? Yes No

6. Have you ever borrowed money from a relative? Yes No

7. Do you own your home? Yes No

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

9. Do you plan on visiting a mall this week? Yes No

10. Do you follow a low-carb diet? Yes No

11. Do you enjoy science fiction/fantasy movies? Yes No

12. Should the ban on new lines of stem cells for research in the U.S. be lifted? Yes No

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

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

15. Do you have any food allergies? Yes No

16. Do you have or use a PDA (Personal Digital Assistant)? Yes No

17. Have you ever spent more than $100 on a pair of shoes? Yes No

18. Did you vote in the last Presidential election? Yes No

19. Do you think you are physically attractive? 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: - Flamenco dancer Jose Greco took out an insurance policy through Lloyd's of London against his pants splitting during a performance. - The candy bar 'Baby Ruth' was named after the daughter of U.S. President Grover Cleveland in 1921. - The tongue is the strongest muscle in the human body. - There are 365 steps on the front of the U.S. Capitol Building - one for every day of the year.

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