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Survey about seasonal allergies, mickey mouse, independent films, brown, religion and smoking.

Begin Survey

1. Do you fly an American flag at home? Yes No

2. Do you suffer from seasonal allergies? Yes No

3. Do you wear glasses/contacts? Yes No

4. Do you like chocolate? Yes No

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

6. Will you attend religious services this week? Yes No

7. Do you own a motorcycle? Yes No

8. Do you plan on visiting a mall this week? Yes No

9. Do you own your own business or work for yourself? Yes No

10. Do you enjoy independent films? Yes No

11. Do you have health insurance? Yes No

12. Do you smoke cigarettes? Yes No

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

14. Do you have children? Yes No

15. Do you have a VCR? Yes No

16. Do you enjoy gambling? Yes No

17. Do you give your children a daily multi-vitamin? Yes No

18. Have you ever been less than honest on your income tax return? Yes No

19. 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: - Mickey Mouse was the first non-human to win an Academy Award (Oscar). - The world's rarest coffee, called Kopi Luwak, costs $300 a pound. - One in 500 humans has one blue eye and one brown eye. - Buckingham Palace has over six hundred rooms.

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