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Survey about restaurants, massage, bed, office supplies, vcr and cholesterol.

Begin Survey

1. Will you order take-out or delivery food from a restaurant this week? Yes No

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

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

4. Will you attend a college sporting event this month? Yes No

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

6. Do you have a VCR? Yes No

7. Do you know your cholesterol level? Yes No

8. Do you ever use a tanning bed? Yes No

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

10. Do you have an annual check-up or exam with your family doctor? Yes No

11. Do you brush your teeth before bed each night? Yes No

12. Do you smoke cigarettes? Yes No

13. Do you own your own business or work for yourself? Yes No

14. Do you have cable or satellite television? Yes No

15. Have you ever gone sky-diving or bungee-jumping? Yes No

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

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

18. Do you think you are intelligent? Yes No

19. Have you eaten fast food this week? 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: - Ralph Lauren's original name is Ralph Lifshitz. - The world's rarest coffee, called Kopi Luwak, costs $300 a pound. - The United States has the highest minimum drinking age in the world. - The tallest building west of the Mississippi River is the Stratosphere Hotel and Casino in Las Vegas, Nevada.

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