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Survey about sandwiches, internet access, circus, cholesterol, peanut butter and car accidents.

Begin Survey

1. Do you use mouthwash? Yes No

2. Do you know your cholesterol level? Yes No

3. Do you have any food allergies? Yes No

4. Do your children attend public schools? Yes No

5. Are your parents still married? Yes No

6. Do you like peanut butter and jelly sandwiches? Yes No

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

8. Are your immunizations up-to-date? Yes No

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

10. Have you ever been in a car accident? Yes No

11. Can you drive a stick shift? Yes No

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

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

14. Have you ever been less than honest on your resume? Yes No

15. Have you ever responded to a personals ad? Yes No

16. Have you ever been in a tornado, earthquake, or other natural disaster? Yes No

17. Have you made your will? Yes No

18. Do you believe in miracles? Yes No

19. Do you fly an American flag at home? 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: - Pierce Brosnan once worked in the circus as a fire eater. - It takes approximately 850 peanuts to make an 18 oz jar of peanut butter. - In the average lifetime a person will breathe in about 44 pounds of dust. - The Library of Congress, located in Washington D.C., is the largest library in the world.

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