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Survey about reading, documentary films, radio, writing, peanut butter and music.

Begin Survey

1. Can you whistle? Yes No

2. Will you visit a therapist or psychiatrist this week? Yes No

3. Will you visit a beauty salon this week? Yes No

4. Do you listen to talk radio? Yes No

5. Have you ever participated in a focus group? Yes No

6. Do enjoy reading or writing poetry? Yes No

7. Will you go to the grocery store this week? Yes No

8. Do you brush your teeth each morning? Yes No

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

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

11. Do you plan on visiting a comedy club this month? Yes No

12. Will you consume any alcoholic beverages this weekend? Yes No

13. Do you have a DVD player? Yes No

14. Do you work outside of the home? Yes No

15. Do you enjoy documentary films? Yes No

16. Do you have children? Yes No

17. Will you use a coupon for any of your purchases this week? Yes No

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

19. Do you know CPR? 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: - Walt Disney named Mickey Mouse after Mickey Rooney, whose mother he dated for some time. - Back in 1953, it took 27 hours to make one Marshmallow Peep. Now it takes only six minutes. - Betty Rubble made her debut as a Flintstones Vitamin in 1996. - The White House kitchen, with its five full-time chefs, is able to serve as many as 140 dinner guests, and hors d’oeuvres to more than 1,000 people.

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