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Survey about pda, suv, bubble baths, wheat, pets and piercings.

Begin Survey

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

2. Do you enjoy hot bubble baths? Yes No

3. Do you enjoy spicy foods? Yes No

4. Do you have a land-line phone in your home? Yes No

5. Have you ever placed a personals ad? Yes No

6. Do you like peanut butter and jelly sandwiches? Yes No

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

8. Do you have any pets? Yes No

9. Are any of your grandparents still alive? Yes No

10. Have you ever cut your own hair? Yes No

11. Do you own or drive an SUV or large truck? Yes No

12. Have you ever won the lottery? Yes No

13. Do you have any piercings? Yes No

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

15. 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: - Blueberry Jelly Bellies were created especially for Ronald Reagan. - Dandelion root can be roasted and ground as a coffee substitute. - The United States produces more tobacco than it does wheat. - The world’s first gas station was opened by the Gulf Refining Company on December 1, 1913, in Pittsburgh, Pennsylvania.

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