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Survey about teeth, comedy clubs, night, latte, cappuccino and jackie kennedy.

Begin Survey

1. Are you left-handed? Yes No

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

3. Do you always wear your safety belt when in a car? Yes No

4. Do you smoke cigarettes? Yes No

5. Do you suffer from seasonal allergies? Yes No

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

7. Have you ever taken dance lessons? Yes No

8. Will you buy an espresso drink (cappuccino, latte etc.) from a coffee house this week? Yes No

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

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

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

12. Do you know CPR? Yes No

13. Do you have any houseplants? Yes No

14. Do you enjoy watching cooking shows? Yes No

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

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

17. Do you have or use an MP3 player? Yes No

18. Will you attend religious services this week? Yes No

19. Do you plan on visiting a comedy club this month? Yes No

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

21. 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: - Jackie Kennedy Onassis was secretly a chain smoker. - Americans eat an average of 18 pounds of fresh apples each year. - The United States produces more tobacco than it does wheat. - 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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