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Survey about teeth, poetry, allergy, buying, charity and health.

Begin Survey

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

2. Do you have any food allergies? Yes No

3. Have you made your will? Yes No

4. Do you have a valid passport? Yes No

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

6. Do enjoy reading or writing poetry? Yes No

7. Have you ever traced your family tree? Yes No

8. Are you a registered voter? Yes No

9. Have you ever cut your own hair? Yes No

10. Do you use charge cards? Yes No

11. Do you enjoy documentary films? Yes No

12. Do you get between 7 to 10 hours of sleep each night? Yes No

13. Do you plan to visit the zoo this year? Yes No

14. Do you enjoy playing video games? Yes No

15. Do you drink enough water (6 8-ounce glasses) every day? Yes No

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

17. Did you drink coffee this morning? Yes No

18. Will you ride on a bus this week? Yes No

19. Do you contribute money to any charitable organizations? Yes No

20. Would you consider yourself to be in good overall health? 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: - Blueberry Jelly Bellies were created especially for Ronald Reagan. - Tootsie Rolls were the first wrapped penny candy in America. - Most dreams last only 5 to 20 minutes. - There are 365 steps on the front of the U.S. Capitol Building - one for every day of the year.

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