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Survey about roller-skating, trips, overall health, dishwashers, airplanes and health.

Begin Survey

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

2. Do you wear cologne or perfume every day? Yes No

3. Do you own a console video game system (Xbox, Playstation 2, GameCube, etc.)? Yes No

4. Do you have a valid passport? Yes No

5. Do you drink diet soda? Yes No

6. Do you suffer from seasonal allergies? Yes No

7. Can you roller-skate, roller-blade, and/or ice-skate? Yes No

8. Do you have any piercings? Yes No

9. Will you be staying at a hotel this week? Yes No

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

11. Do you use chewing tobacco? Yes No

12. Do you plan on taking a trip by airplane this week? Yes No

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

14. Do you own a Bible, Koran, or other religious book? Yes No

15. Do you use a dishwasher to do your dishes? Yes No

16. Do you attend regular religious services? Yes No

17. Would you consider yourself to be in good overall health? Yes No

18. Do you fly an American flag at home? Yes No

19. Have you ever traveled by airplane? Yes No

20. Do you have any pets? 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:

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Yes, I would like to join the Daily Life Survey!

Fun and Interesting facts: - Charlie Chaplin once won third prize in a Charlie Chaplin look alike contest. - The U.S. Government spent $277,000 on pickle research in 1993. - A blink lasts approximately 0.3 seconds. - Lake Michigan is the largest lake in the United States.

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