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Survey about musical instruments, health, fantasy, cocaine, science fiction and money.

Begin Survey

1. Do you enjoy reading non-fiction books for pleasure? Yes No

2. Do you plan on visiting a comedy club this month? Yes No

3. Do you play any musical instruments? Yes No

4. Have you ever eaten rattlesnake meat? Yes No

5. Do you have any piercings? Yes No

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

7. Do you know CPR? Yes No

8. Do you have any phobias? Yes No

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

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

11. Do you contribute money to any charitable organizations? Yes No

12. Did you drink coffee this morning? Yes No

13. Do you use online banking? 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: - Charlie Chaplin once won third prize in a Charlie Chaplin look alike contest. - The candy bar 'Baby Ruth' was named after the daughter of U.S. President Grover Cleveland in 1921. - Hailed as a wonder drug in the late nineteenth century, cocaine was outlawed in the United States in 1914. - Lake Michigan is the largest lake in the United States.

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