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Survey about movies, honesty, dvds, road rage, psychiatrists and guns.

Begin Survey

1. Do you have any pets? Yes No

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

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

4. Do you own a Bible, Koran, or other religious book? Yes No

5. Will you rent a DVD or video this weekend? Yes No

6. Do you suffer from seasonal allergies? Yes No

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

8. Do you smoke cigarettes? Yes No

9. Do you brush your teeth each morning? Yes No

10. Do you plan to visit the zoo this year? Yes No

11. Do you own a gun? Yes No

12. Will you use a coupon for any of your purchases this week? Yes No

13. Do you have road rage? Yes No

14. Will you go see a new-release movie at a theater this week? Yes No

15. 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: - Wilma Flintstone's maiden name was Wilma Slaghoopal. - In 2003, the U.S. Government spent about $2,000,000 on potato research. - Only 25% of Americans eat three meals a day. - In Washington D.C., no building may be built taller than the Washington Monument.

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