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Survey about motorcycles, singing, charge cards, car accidents, intelligent and acne.

Begin Survey

1. Do you use charge cards? Yes No

2. Would you consider yourself to be in good overall health? Yes No

3. Do you have any phobias? Yes No

4. Do you eat breakfast every morning? Yes No

5. Do you enjoy cooking or baking? Yes No

6. Can you roller-skate, roller-blade, and/or ice-skate? Yes No

7. Have you ever been in a car accident? Yes No

8. Do you think you are intelligent? Yes No

9. Will you visit a doctor this week? Yes No

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

11. Do you own a motorcycle? Yes No

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

13. Do you ever dye your hair? Yes No

14. Do you have any siblings? Yes No

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

16. Do you sing in the shower? Yes No

17. Do you play any musical instruments? Yes No

18. 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: - Charlie Chaplin once won third prize in a Charlie Chaplin look alike contest. - Chocolate does not cause acne. - The United States produces more tobacco than it does wheat. - Buckingham Palace has over six hundred rooms.

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