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Survey about roller coasters, soft drinks, doctors, diet soda, movies and mouthwash.

Begin Survey

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

2. Do you have Internet access at home? Yes No

3. Do you own at least one pair of blue jeans? Yes No

4. Do you enjoy roller coasters? Yes No

5. Do you believe there is life on other planets? Yes No

6. Have you ever been the target of identity theft? Yes No

7. Do you give your children a daily multi-vitamin? Yes No

8. Do you watch Saturday morning cartoons? Yes No

9. Do you enjoy gambling? Yes No

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

11. Do you use mouthwash? Yes No

12. Do you drink diet soda? Yes No

13. Do you have health insurance? Yes No

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

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

16. Will you go see a new-release movie at a theater this week? Yes No

17. Do you have children? Yes No

18. Do you know how to fly an airplane? Yes No

19. 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: - Flamenco dancer Jose Greco took out an insurance policy through Lloyd's of London against his pants splitting during a performance. - The world's rarest coffee, called Kopi Luwak, costs $300 a pound. - Men are 6 times more likely to be struck by lightning than women. - Lake Michigan is the largest lake in the United States.

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