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Survey about physical activity, volunteers, coffee house, manhattan island, phobias and lotteries.

Begin Survey

1. Do you have or use a cellular phone? Yes No

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

3. Do you have any phobias? Yes No

4. Will you see a play this month? Yes No

5. Do you have health insurance? Yes No

6. Do you have or use an MP3 player? Yes No

7. Have you ever won the lottery? Yes No

8. Have you ever eaten fried green tomatoes? Yes No

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

10. Are you involved in volunteerism? Yes No

11. Do you suffer from seasonal allergies? Yes No

12. Do you take a bagged lunch to work every day? Yes No

13. Will you buy an espresso drink (cappuccino, latte etc.) from a coffee house this week? Yes No

14. Will you engage in rigorous physical activity at least three times this week? 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: - Albert Einstein never wore any socks. - Honey is the only food that will not spoil. - Women blink nearly twice as much as men. - Manhattan Island of New York City was purchased for $24 from the Algonquian Indians in 1624.

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