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Survey about passports, kernels, flu, food, honesty and charlie chaplin.

Begin Survey

1. Do you have any food allergies? Yes No

2. Do you have a retirement investment account (401k, IRA, etc.)? Yes No

3. Have you ever gotten a traffic ticket? Yes No

4. Should the ban on new lines of stem cells for research in the U.S. be lifted? Yes No

5. Do you eat lunch every day? Yes No

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

7. Do you own a console video game system (Xbox, Playstation 2, GameCube, etc.)? Yes No

8. Do you get a flu shot every winter? Yes No

9. Will you plant a vegetable and/or flower garden this year? Yes No

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

11. Have you graduated from (or finished) college? Yes No

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

13. Are your immunizations up-to-date? Yes No

14. Do you drink enough water (6 8-ounce glasses) every day? Yes No

15. Do you have a valid passport? Yes No

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

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

18. Do you eat breakfast every morning? 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: - Charlie Chaplin once won third prize in a Charlie Chaplin look alike contest. - Ears of corn always have an even number of rows of kernels. - A yawn usually lasts for approximately six seconds. - On a clear day, you can see five states from atop the Empire State Building in New York City: New York, New Jersey, Connecticut, Massachusetts, and Pennsylvania.

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