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Survey about night clubs, shower, road rage, malls, allergy and new jersey.

Begin Survey

1. Do you belong to a credit union? Yes No

2. Do you enjoy reality television? Yes No

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

4. Do you use chewing tobacco? Yes No

5. Do you have a sit-down family dinner every night? Yes No

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

7. Do you plan on visiting a mall this week? Yes No

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

9. Do you belong to a labor union? Yes No

10. Do you have road rage? Yes No

11. Will you travel outside of the U.S. this year? Yes No

12. Do you enjoy board games? Yes No

13. Did you drink coffee this morning? Yes No

14. Do you shower at least once daily? Yes No

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

16. Do you have any food allergies? Yes No

17. Have you ever traced your family tree? 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: - Leonardo da Vinci was dyslexic. - Chocolate does not cause acne. - More people have a phobia of frogs than rats. - Ho-Ho-Kus, a small town in New Jersey, is the only town in the United States of America that has two dashes in its name.

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