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Survey about road rage, drugs, religious services, smoking, morning and crime.

Begin Survey

1. Will you ride on a bus this week? Yes No

2. Do you enjoy ethnic foods? Yes No

3. Do you think you are physically attractive? Yes No

4. Do you plan on visiting the public library this week? Yes No

5. Do you wear mittens? Yes No

6. Will you balance your checkbook this week? Yes No

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

8. Do you smoke cigarettes? Yes No

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

10. Do you enjoy television police/crime dramas? Yes No

11. Did you drink coffee this morning? Yes No

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

13. Have you ever broken any bones? Yes No

14. Have you ever won the lottery? Yes No

15. Do you have road rage? Yes No

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

17. Do you enjoy hunting or fishing? Yes No

18. 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: - Daniel Boone hated coonskin caps. - Strawberries are a member of the rose family. - Hailed as a wonder drug in the late nineteenth century, cocaine was outlawed in the United States in 1914. - 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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