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Survey about sears tower, teeth, night, coca-cola, chicago and identity theft.

Begin Survey

1. Do you have children? Yes No

2. Do you have a land-line phone in your home? Yes No

3. Do you smoke cigarettes? Yes No

4. Do you enjoy reality television? Yes No

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

6. Do you drink enough water (6 8-ounce glasses) every day? Yes No

7. Do you drink milk? Yes No

8. Do you have road rage? Yes No

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

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

11. Do you enjoy board games? Yes No

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

13. Do you have a valid passport? Yes No

14. Do you plan to visit any U.S. National Parks this year? Yes No

15. Do you know your cholesterol level? Yes No

16. Will you ride on a bus this week? 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: - Ralph Lauren's original name is Ralph Lifshitz. - Coca-Cola was the first soft drink to be consumed in outer space. - 80% of people over 100 years old are women. - The Sears Tower in Chicago has its own zip code.

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