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Survey about travel, teeth, grandparents, religious services, sky-diving and cyanide.

Begin Survey

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

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

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

4. Do you believe in miracles? Yes No

5. Do you have a VCR? Yes No

6. Do you listen to the radio in the car? Yes No

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

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

9. Do you own a matching set of luggage? Yes No

10. Do you enjoy cooking or baking? Yes No

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

12. Are any of your grandparents still alive? Yes No

13. 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: - Al Capone's business card said he was a used furniture dealer. - Lima beans contain cyanide. - Blue eyes are the most sensitive to light (hence they can see better in the dark); brown the least sensitive. - The world’s first gas station was opened by the Gulf Refining Company on December 1, 1913, in Pittsburgh, Pennsylvania.

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