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Survey about pda, hair, health insurance, gambling, religious services and family tree.

Begin Survey

1. Have you ever broken any bones? Yes No

2. Are your parents still married? Yes No

3. Do you have health insurance? Yes No

4. Do you have Internet access at home? Yes No

5. Will you go see a new-release movie at a theater this week? Yes No

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

7. Do you enjoy cooking or baking? Yes No

8. Do you enjoy gambling? Yes No

9. Have you ever traced your family tree? Yes No

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

11. Do you subscribe to your local newspaper? Yes No

12. Do you have or use a PDA (Personal Digital Assistant)? Yes No

13. Do you drink diet soda? Yes No

14. Do you ever dye your hair? Yes No

15. Will you attend religious services this week? Yes No

16. Do you have a swimming pool? Yes No

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

18. 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. - Ears of corn always have an even number of rows of kernels. - Babies are born without knee caps. - There are 10 towns/cities named Hollywood in the United States.

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