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Survey about religion, shopping, disasters, road rage, wills and smoking.

Begin Survey

1. Have you ever spent more than $100 on a pair of shoes? Yes No

2. Have you made your will? Yes No

3. Do you subscribe to your local newspaper? Yes No

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

5. Do you own a dictionary and/or thesaurus? Yes No

6. Do you wear glasses/contacts? Yes No

7. Do you read the comics? Yes No

8. Do you wear a watch every day? Yes No

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

10. Have you ever taken dance lessons? Yes No

11. Do you have road rage? Yes No

12. Do you have health insurance? Yes No

13. Do you have any food allergies? Yes No

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

15. Are you a registered voter? Yes No

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

17. Will you be visiting any theme parks this year? Yes No

18. Are you married? Yes No

19. Have you ever been in a tornado, earthquake, or other natural disaster? Yes No

20. Do you smoke cigarettes? Yes No

21. 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: - Deborah Winger did the voice of E.T. - Apples are a member of the rose family. - Only 1 person in 2 billion will live to be 116. - Buckingham Palace has over six hundred rooms.

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