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Survey about safety belt, marriage, foreigners, health, flu and independent films.

Begin Survey

1. Do you keep an umbrella in your car? Yes No

2. Do you get a flu shot every winter? Yes No

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

4. Have you ever been rock or mountain climbing? Yes No

5. Will you attend a professional sporting event this month? Yes No

6. Are you married? Yes No

7. Do you always wear your safety belt when in a car? Yes No

8. Do you believe in Santa Claus? Yes No

9. Do you have road rage? Yes No

10. Have you ever broken any bones? Yes No

11. Do you use chewing tobacco? Yes No

12. Do you sleep with a pillow at night? Yes No

13. Have you ever spent more than $100 on a pair of shoes? Yes No

14. Do you enjoy independent films? Yes No

15. Do you brush your teeth each morning? Yes No

16. Do you speak any foreign languages? Yes No

17. 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: - Oil tycoon John D. Rockefeller was the world's first billionaire. - Headache pain can be reduced by eating 20 tart cherries. - More people have a phobia of frogs than rats. - Air conditioners completely recycle the air throughout the Empire State Building about every 10 minutes.

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