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Survey about night, jelly, sleep, religion, marriage and poetry.

Begin Survey

1. Do enjoy reading or writing poetry? Yes No

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

3. Do you have any phobias? Yes No

4. Do you like peanut butter and jelly sandwiches? Yes No

5. Do you always wear your safety belt when in a car? Yes No

6. Are you married? Yes No

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

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

9. Do you wear cologne or perfume every day? Yes No

10. Do you ever download music from the Internet? Yes No

11. Can you roller-skate, roller-blade, and/or ice-skate? Yes No

12. Will you balance your checkbook this week? Yes No

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

14. Do you have children? Yes No

15. Do you own a gun? Yes No

16. Do you follow a low-carb diet? Yes No

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

18. Do you get between 7 to 10 hours of sleep each night? 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: - Of the six men who made up the Three Stooges, three of them were real brothers (Moe, Curly and Shemp.) - Americans eat an average of 18 pounds of fresh apples each year. - Only 25% of Americans eat three meals a day. - The very peak of the Washington Monument is not stone, but a 100-ounce solid aluminum pyramid, constructed as part of the monument's lightning protection system.

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