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Survey about traffic tickets, newspapers, earthquakes, slippers, hollywood and night clubs.

Begin Survey

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

2. Can you roller-skate, roller-blade, and/or ice-skate? Yes No

3. Do you take a daily multi-vitamin? Yes No

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

5. Do you smoke cigarettes? Yes No

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

7. Do you follow a vegetarian diet? Yes No

8. Are your parents still married? Yes No

9. Do you have any piercings? Yes No

10. Have you ever been in a tornado, earthquake, or other natural disaster? Yes No

11. Do you own or use a digital camera? Yes No

12. Have you ever been tested for HIV? Yes No

13. Do you have a DVD player? Yes No

14. Have you ever gotten a traffic ticket? Yes No

15. Do you own a pair of fuzzy bunny slippers? Yes No

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

17. Do you own a boat, camper, or other recreational vehicle? 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: - 20252 is Smokey the Bear's own zip code. - The candy bar 'Baby Ruth' was named after the daughter of U.S. President Grover Cleveland in 1921. - Your thumb is the same length as your nose. - There are 10 towns/cities named Hollywood in the United States.

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