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Survey about zip codes, latte, light, cars, health insurance and niagara falls.

Begin Survey

1. Do you always wear your safety belt when in a car? Yes No

2. Do you own a motorcycle? Yes No

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

4. Do you take any prescribed daily medications? Yes No

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

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

7. Do you have children? Yes No

8. Will you see a play this month? Yes No

9. Do you plan on visiting a mall this week? Yes No

10. Do you have a retirement investment account (401k, IRA, etc.)? Yes No

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

12. Will you visit a doctor this week? Yes No

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

14. Do you have health insurance? Yes No

15. Do you have road rage? Yes No

16. Do you wear a watch every day? Yes No

17. 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. - Coca-Cola was the first soft drink to be consumed in outer space. - Between 25% to 33% of people sneeze when they are exposed to light. - Niagara Falls is constantly moving backwards. The rim is worn down about two and a half feet each year because of the millions of gallons of water that rush over it every minute.

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