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Survey about sleep, checkbooks, religion, science fiction, new jersey and ho-ho-kus.

Begin Survey

1. Will you balance your checkbook this week? Yes No

2. Do you get between 7 to 10 hours of sleep each night? Yes No

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

4. Do you enjoy reality television? Yes No

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

6. Do you enjoy roller coasters? Yes No

7. Do you know your cholesterol level? Yes No

8. Do you enjoy ethnic foods? Yes No

9. Do you have a valid passport? Yes No

10. Do you have any piercings? Yes No

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

12. Do you splash in mud puddles? Yes No

13. Do you attend regular religious services? Yes No

14. Do you have any houseplants? Yes No

15. Do you take a bagged lunch to work every day? Yes No

16. Do you believe in karma? Yes No

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

18. 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: - Henry Ford, father of the assembly line, also invented the charcoal briquette. - The average strawberry has about 200 seeds on it. - After the age of 35, about 1 in 27 women will give birth to twins. After 50, the chances of having twins is 1 in 9. - Ho-Ho-Kus, a small town in New Jersey, is the only town in the United States of America that has two dashes in its name.

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