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Survey about satellite, coffee house, capitol building, sandwiches, retirement and koran.

Begin Survey

1. Will you buy an espresso drink (cappuccino, latte etc.) from a coffee house this week? Yes No

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

3. Will you be taking any road trips this week (over 50 miles)? Yes No

4. Do you have a retirement investment account (401k, IRA, etc.)? Yes No

5. Do you enjoy science fiction/fantasy movies? Yes No

6. Do you play any musical instruments? Yes No

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

8. Have you ever been tested for HIV? Yes No

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

10. Do you smoke cigarettes? Yes No

11. Have you ever eaten rattlesnake meat? Yes No

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

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

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

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

16. Do you own a matching set of luggage? Yes No

17. Do you plan to visit the zoo this year? Yes No

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

19. Do you always wear your safety belt when in a car? 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: - Mr. Rogers was an ordained minister. - After the 'Popeye' comic strip was launched in 1931, spinach consumption went up by thirty-three percent in the United States. - The human brain stops growing at the age of 18. - There are 365 steps on the front of the U.S. Capitol Building - one for every day of the year.

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