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Survey about shoes, cappuccino, traffic tickets, psychiatrists, capitol building and overall health.

Begin Survey

1. Do you believe there is life on other planets? Yes No

2. Do you have a swimming pool? Yes No

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

4. Would you consider yourself to be in good overall health? Yes No

5. Did you drink coffee this morning? Yes No

6. Do you follow a vegetarian diet? Yes No

7. Do you wear sandals/flip-flops in the summer? Yes No

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

9. Will you visit a therapist or psychiatrist this week? Yes No

10. Have you ever broken any bones? Yes No

11. Will you ride on a bus this week? Yes No

12. Have you ever gotten a traffic ticket? Yes No

13. 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: - Daniel Boone hated coonskin caps. - Back in 1953, it took 27 hours to make one Marshmallow Peep. Now it takes only six minutes. - Half of all Americans over the age of 55 have no teeth. - There are 365 steps on the front of the U.S. Capitol Building - one for every day of the year.

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