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Survey about nose, beverages, family, cappuccino, poetry and coffee house.

Begin Survey

1. Do you have a valid passport? Yes No

2. Do enjoy reading or writing poetry? Yes No

3. Do you plan on performing any community service this week? Yes No

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

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

6. Do you own a first aid kit? Yes No

7. Do you enjoy gambling? Yes No

8. Do you listen to talk radio? Yes No

9. Have you ever responded to a personals ad? Yes No

10. Do you have children? Yes No

11. Do you splash in mud puddles? Yes No

12. Do you have any houseplants? Yes No

13. Do you wear sunscreen every day? Yes No

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

15. Do you enjoy hunting or fishing? Yes No

16. Do you use charge cards? Yes No

17. Do you use mouthwash? Yes No

18. Will you buy an espresso drink (cappuccino, latte etc.) from a coffee house this week? Yes No

19. Do you believe in miracles? 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: - Jimi Hendrix, Janis Joplin, and Jim Morrison were all 27 years old when they died. - The Massachusetts state beverage is Cranberry Juice. - Your thumb is the same length as your nose. - Niagara Falls is constantly moving backwards. The rim is worn down about two and a half feet each year because of the millions of gallons of water that rush over it every minute.

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