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Survey about physical activity, night, houseplants, blood plasma, swimming pools and charity.

Begin Survey

1. Do you think you are intelligent? Yes No

2. Do you have health insurance? Yes No

3. Do you enjoy Girl Scout cookies? Yes No

4. Do you give your children a daily multi-vitamin? Yes No

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

6. Do you contribute money to any charitable organizations? Yes No

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

8. Do you ever download music from the Internet? Yes No

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

10. Do you have a swimming pool? Yes No

11. Do you have any houseplants? Yes No

12. Can you drive a stick shift? Yes No

13. Do you have an annual check-up or exam with your family doctor? Yes No

14. Do you enjoy roller coasters? Yes No

15. Do you own a motorcycle? Yes No

16. Have you ever had a professional massage? Yes No

17. Do you sleep with a pillow at night? Yes No

18. Have you ever borrowed money from a relative? Yes No

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

20. 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: - Oil tycoon John D. Rockefeller was the world's first billionaire. - A cup of coffee has 12 times the amount of caffeine as a cup of cocoa. - The liquid inside young coconuts can be used as a substitute for blood plasma. - The tallest building west of the Mississippi River is the Stratosphere Hotel and Casino in Las Vegas, Nevada.

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