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Survey about newspapers, coffeine, family, physical activity, glasses and vegetables.

Begin Survey

1. Do you watch the evening news? Yes No

2. Do you wear glasses/contacts? Yes No

3. Do you have a DVD player? Yes No

4. Do you think you are physically attractive? Yes No

5. Do you have a savings account? Yes No

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

7. Have you ever taken dance lessons? Yes No

8. Do you enjoy hot bubble baths? Yes No

9. Will you engage in rigorous physical activity at least three times this week? Yes No

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

11. Do you take any prescribed daily medications? Yes No

12. Do you suffer from seasonal allergies? Yes No

13. Should government employees be randomly tested for illicit drug use? Yes No

14. Will you plant a vegetable and/or flower garden this year? Yes No

15. Do you believe in love at first sight? Yes No

16. Have you ever been in love? Yes No

17. Do you subscribe to your local newspaper? Yes No

18. Do you have a swimming pool? Yes No

19. Do you enjoy cat-naps? 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: - Napoleon constructed his battle plans in a sandbox. - A cup of coffee has 12 times the amount of caffeine as a cup of cocoa. - Coconuts kill more people in the world than sharks do. Approximately 150 people are killed each year by coconuts. - Built in 1967, the world’s only flying saucer launching pad is in St. Paul, Alberta, Canada.

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