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Survey about teeth, central park, jelly, holidays, sky-diving and alcoholic beverages.

Begin Survey

1. Do you enjoy playing video games? Yes No

2. Have you ever gone sky-diving or bungee-jumping? Yes No

3. Do you have any houseplants? Yes No

4. Do you wear sunscreen every day? Yes No

5. Do you enjoy documentary films? Yes No

6. Will you send anyone a printed holiday, birthday, or anniversary card this week? Yes No

7. Do you have any pets? Yes No

8. Do you splash in mud puddles? Yes No

9. Have you ever broken any bones? Yes No

10. Do you have any tattoos? Yes No

11. Do you brush your teeth before bed each night? Yes No

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

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

14. Do you get a flu shot every winter? Yes No

15. Will you go to a bar or night club this week? Yes No

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

17. Do you believe in miracles? Yes No

18. Do you have any camping trips planned for this summer? Yes No

19. Do you follow a low-carb diet? 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: - Blueberry Jelly Bellies were created especially for Ronald Reagan. - A hardboiled egg will spin. An uncooked or softboiled egg will not. - Your thumb is the same length as your nose. - New York's Central Park is nearly twice the size of the entire country of Monaco.

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