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Survey about religion, income tax, cars, multi-vitamin, oscars and children.

Begin Survey

1. Do your children attend public schools? Yes No

2. Do you have any siblings? Yes No

3. Do you take a daily multi-vitamin? Yes No

4. Have you ever been less than honest on your income tax return? Yes No

5. Do you know your cholesterol level? Yes No

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

7. Have you ever pilfered office supplies from work? Yes No

8. Do you follow a low-carb diet? Yes No

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

10. Do you own a pair of fuzzy bunny slippers? Yes No

11. Do you get a flu shot every winter? Yes No

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

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

14. Have you eaten fast food this week? Yes No

15. Do you have any phobias? Yes No

16. Will you visit a hardware or home improvement store this week? Yes No

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

18. Will you buy plants or flowers from a florist this week? Yes No

19. Do you drink milk? 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: - Mickey Mouse was the first non-human to win an Academy Award (Oscar). - A cup of coffee has 12 times the amount of caffeine as a cup of cocoa. - Coconuts kill more people in the world than sharks do. Approximately 150 people are killed each year by coconuts. - Ho-Ho-Kus, a small town in New Jersey, is the only town in the United States of America that has two dashes in its name.

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