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Survey about overall health, speed limit, broken bones, lifshitz, cookies and road trips.

Begin Survey

1. Have you ever spent a day at a spa? Yes No

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

3. Do you know CPR? Yes No

4. Would you consider yourself to be in good overall health? Yes No

5. Do you enjoy Girl Scout cookies? Yes No

6. Will you visit a casino this week? Yes No

7. Have you ever purchased or sold anything on eBay? Yes No

8. Have you ever broken any bones? Yes No

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

10. Do you always drive within the posted speed limit? Yes No

11. Have you ever been the target of identity theft? Yes No

12. Have you ever pilfered office supplies from work? Yes No

13. Do you have a checking account? Yes No

14. Do you eat lunch every day? Yes No

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

16. Do you own a matching set of luggage? Yes No

17. Will you be taking any road trips this week (over 50 miles)? Yes No

18. Do you enjoy ethnic foods? Yes No

19. Will you visit a doctor this week? Yes No

20. Do you enjoy playing video games? Yes No

21. 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: - Ralph Lauren's original name is Ralph Lifshitz. - The '57' on the bottle of Heinz ketchup stands for the number of pickle varieties they once offered. - Babies are born without knee caps. - The tallest building west of the Mississippi River is the Stratosphere Hotel and Casino in Las Vegas, Nevada.

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