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Survey about teeth, night, religion, pillow, family and dyslexic.

Begin Survey

1. Do you belong to a labor union? Yes No

2. Do you have an annual check-up or exam with your family doctor? Yes No

3. Do you own a Bible, Koran, or other religious book? Yes No

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

5. Have you eaten fast food this week? Yes No

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

7. Will you engage in rigorous physical activity at least three times this week? Yes No

8. Will you use a coupon for any of your purchases this week? Yes No

9. Do you have a VCR? Yes No

10. Do you have a land-line phone in your home? Yes No

11. Do you have a valid passport? Yes No

12. Do you enjoy ethnic foods? Yes No

13. Do you sleep with a pillow at night? Yes No

14. Have you ever purchased or sold anything on eBay? Yes No

15. Do you have or use a cellular phone? Yes No

16. Have you ever responded to a personals ad? Yes No

17. Do you enjoy roller coasters? Yes No

18. 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: - Leonardo da Vinci was dyslexic. - Honey is the only food that will not spoil. - Your heart rate can rise as much as 30% during a yawn. - The tallest building west of the Mississippi River is the Stratosphere Hotel and Casino in Las Vegas, Nevada.

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