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Survey about religious services, tootsie rolls, travel, blue jeans, work and vegetables.

Begin Survey

1. Do you like chocolate? Yes No

2. Do you have health insurance? Yes No

3. Do you own your home? Yes No

4. Do you enjoy board games? Yes No

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

6. Will you visit a doctor this week? Yes No

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

8. Do you own a matching set of luggage? Yes No

9. Do you ever download movies from the Internet? Yes No

10. Will you plant a vegetable and/or flower garden this year? Yes No

11. Do you take any prescribed daily medications? Yes No

12. Have you ever cut your own hair? Yes No

13. Do you wear mittens? Yes No

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

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

16. 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: - Frank Sinatra never wore or owned a pair of blue jeans. - Tootsie Rolls were the first wrapped penny candy in America. - More children are allergic to cockroaches than cats - The first lighthouse to use electricity was the Statue of Liberty in 1886.

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