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Survey about passports, fortune cookies, doctors, employment, george jung and santa claus.

Begin Survey

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

2. Do you enjoy roller coasters? Yes No

3. Do you splash in mud puddles? Yes No

4. Do you ever dye your hair? Yes No

5. Do you have health insurance? Yes No

6. Do you believe in Santa Claus? Yes No

7. Did you drink coffee this morning? Yes No

8. Do you belong to any professional organizations? Yes No

9. Will you ride on a bus this week? Yes No

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

11. Do you enjoy gambling? Yes No

12. Do you think professional athletes should be regularly screened for illicit drug use? Yes No

13. Do you have a VCR? Yes No

14. Do you have a valid passport? Yes No

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

16. Are you satisfied in your current employment? Yes No

17. 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: - Houdini was the first man to fly a plane solo in Australia. - The fortune cookie was invented in 1916 by George Jung, a Los Angeles noodlemaker. - The human brain stops growing at the age of 18. - The State of Louisiana was named after the French King Louis XIV.

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