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Survey about smoking, love, teeth, casinos, drugs and languages.

Begin Survey

1. Do you have children? Yes No

2. Do you have a checking account? Yes No

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

4. Will you visit a hardware or home improvement store this week? Yes No

5. Do you like peanut butter and jelly sandwiches? Yes No

6. Do you enjoy Girl Scout cookies? Yes No

7. Do you smoke cigarettes? Yes No

8. Do you have any food allergies? Yes No

9. Do you work outside of the home? Yes No

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

11. Do you speak any foreign languages? Yes No

12. Do you have any piercings? Yes No

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

14. Have you made your will? Yes No

15. Do you brush your teeth after lunch? 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: - Alfred Hitchcock didn't have a belly button. - Nutmeg is extremely poisonous if injected intravenously. - In the year 1900,aspirin was the first drug was offered as a water-soluble tablet. - In Washington D.C., no building may be built taller than the Washington Monument.

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