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Survey about slippers, travel, newspapers, theaters, documentary films and broken bones.

Begin Survey

1. Do you enjoy documentary films? Yes No

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

3. Have you ever been arrested? Yes No

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

5. Do you own a pair of fuzzy bunny slippers? Yes No

6. Do enjoy reading or writing poetry? Yes No

7. Will you be staying at a hotel this week? Yes No

8. Do you subscribe to your local newspaper? Yes No

9. Do you believe in destiny or fate? Yes No

10. Will you go see a new-release movie at a theater this week? Yes No

11. Have you ever broken any bones? Yes No

12. Do you have a checking account? Yes No

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

14. Have you ever been in a car accident? Yes No

15. Do you have any pets? Yes No

16. Do you believe in love at first sight? Yes No

17. Do you drink diet soda? Yes No

18. Do you wear cologne or perfume every day? Yes No

19. Are you satisfied in your current employment? Yes No

20. 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: - Mr. Rogers was an ordained minister. - Non-dairy creamer is flammable. - A blink lasts approximately 0.3 seconds. - Buckingham Palace has over six hundred rooms.

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