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Survey about umbrella, ralph lauren, espresso, airplanes, peanut butter and broken bones.

Begin Survey

1. Do you have Internet access at home? Yes No

2. Have you ever broken any bones? Yes No

3. Do you have children? Yes No

4. Should the ban on new lines of stem cells for research in the U.S. be lifted? Yes No

5. Do you enjoy gambling? Yes No

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

7. Do you keep an umbrella in your car? Yes No

8. Do you know your cholesterol level? Yes No

9. Have you ever traveled by airplane? Yes No

10. Are you a veteran? Yes No

11. Will you go to the grocery store this week? Yes No

12. Are you married? Yes No

13. Have you ever been the target of identity theft? Yes No

14. Do you eat lunch every day? Yes No

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

16. Do you own a first aid kit? Yes No

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

18. Will you go see a new-release movie at a theater this week? Yes No

19. Do you have any piercings? Yes No

20. 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: - Ralph Lauren's original name is Ralph Lifshitz. - It takes approximately 850 peanuts to make an 18 oz jar of peanut butter. - One in 500 humans has one blue eye and one brown eye. - The Hollywood sign was first erected in 1923. It was first erected as 'Hollywoodland.'

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