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Survey about wills, shopping, water, apples, health and volunteers.

Begin Survey

1. Will you visit a therapist or psychiatrist this week? Yes No

2. Do you enjoy watching cooking shows? Yes No

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

4. Do you have or use a PDA (Personal Digital Assistant)? Yes No

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

6. Do you enjoy documentary films? Yes No

7. Do you use charge cards? Yes No

8. Will you be taking any road trips this week (over 50 miles)? Yes No

9. Have you made your will? Yes No

10. Do you like chocolate? Yes No

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

12. Are you involved in volunteerism? Yes No

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

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

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

16. Do you play any organized team sports? Yes No

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

18. Do you follow a low-carb diet? Yes No

19. Do you have any camping trips planned for this summer? 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: - Charlie Chaplin once won third prize in a Charlie Chaplin look alike contest. - Americans eat an average of 18 pounds of fresh apples each year. - During their lifetime, the average human will grow 590 miles of hair. - Hawaii has the only royal palace in the United States – Iolani.

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