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Survey about sears tower, teeth, bubble baths, passports, family and movies.

Begin Survey

1. Do you have an annual check-up or exam with your family doctor? Yes No

2. Do you have or use a cellular phone? Yes No

3. Do you enjoy hot bubble baths? Yes No

4. Do you have a VCR? Yes No

5. Do you know CPR? Yes No

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

7. Do you have a valid passport? Yes No

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

9. Do you brush your teeth before bed each night? Yes No

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

11. Do you ever download movies from the Internet? Yes No

12. Have you graduated from (or finished) college? Yes No

13. Should government employees be randomly tested for illicit drug use? Yes No

14. Would you consider yourself an avid sports fan? Yes No

15. Did you vote in the last Presidential election? Yes No

16. Do you have road rage? 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. - Tootsie Rolls were the first wrapped penny candy in America. - Most dreams last only 5 to 20 minutes. - The Sears Tower in Chicago has its own zip code.

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