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Survey about smoking, health, work, hair, garden and grocery stores.

Begin Survey

1. Do you have road rage? Yes No

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

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

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

5. Do you ever dye your hair? Yes No

6. Do you smoke cigarettes? Yes No

7. Do you have a savings account? Yes No

8. Will you visit a casino this week? Yes No

9. Will you order take-out or delivery food from a restaurant this week? Yes No

10. Have you ever participated in a focus group? Yes No

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

12. Will you go to the grocery store this week? Yes No

13. Do you ever download music from the Internet? Yes No

14. Will you plant a vegetable and/or flower garden this year? Yes No

15. Do you know how to fly an airplane? Yes No

16. 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. - Americans eat an average of 18 pounds of fresh apples each year. - During their lifetime, the average human will grow 590 miles of hair. - New York's Central Park is nearly twice the size of the entire country of Monaco.

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