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Survey about multi-vitamin, coffee, family, john d rockefeller, morning and dance lessons.

Begin Survey

1. Did you drink coffee this morning? Yes No

2. Do you take a daily multi-vitamin? Yes No

3. Do you ever use a tanning bed? Yes No

4. Do you use charge cards? Yes No

5. Have you ever eaten rattlesnake meat? Yes No

6. Do you have or use a cellular phone? Yes No

7. Do you drink diet soda? Yes No

8. Can you whistle? Yes No

9. Will you order take-out or delivery food from a restaurant this week? Yes No

10. Will you buy a lottery ticket this week? Yes No

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

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

13. Do you own or use a digital camera? Yes No

14. Do you have an annual check-up or exam with your family doctor? Yes No

15. Have you ever taken dance lessons? Yes No

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

17. Do you wear a watch every day? Yes No

18. Do you have Internet access at home? Yes No

19. 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: - Oil tycoon John D. Rockefeller was the world's first billionaire. - Nutmeg is extremely poisonous if injected intravenously. - Coconuts kill more people in the world than sharks do. Approximately 150 people are killed each year by coconuts. - The Statue of Liberty is one hundred fifty one feet and one inch tall. Her index finger is eight feet long, her fingernails are thirteen inches long, and her nose is four and a half feet long.

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