You may submit your survey anonymously by checking the box to the left.

1.   What gender are you? (R)

      Female Male Other None of your damn business!

2.   What age group are you in? (R)

        Under 13 (get out of here!!!)
        13-18 (too young for this survey!)
        18-25
        25-35
        35-50
        Over 50
        None of your damn business

3.   Where are you from? (R)

        United States
        United Kingdom
        Other European country
        Asia
        Australia/NZ
        South America
        Other

4.   What is your sexual preference? (R)

        Hetero
        Homo
        Bi
        Celibate
        You don't wanna know
        Other
        None of your business!

5.   How many people have you had sexual relations of some kind with? (R)

        None
        Only one
        2-10
        11-25
        26-45
        46-100
        Over 100

6.   What is your opinion on bestiality (having sex with animals) (R)

        Disgusting! Ewwwwwwwww!
        I've thought about it
        I know someone who's done it
        I want to do it, but am scared
        I have done it
        I do it all the time
        Refuse to comment

7.   You have to choose one...which do you choose? (R)

        Being torn apart by wolverines
        Being forced to live alone on a deserted island
        Becoming deaf, blind and mute
        Becoming immortal but all your loved ones die
        Becoming wealthy but can't ever see your family again
        Having your arms and legs cut off
        Being raped by twelve very large men

8.   You have to pick one, again. What do you choose? (R)

        You become a vampire
        You become a werewolf
        You become a zombie
        You are kidnapped by aliens
        You are trapped in a den of cobras
        You can only eat carrots for the rest of your life
        You are turned into an eggplant

9.   Which soda do you prefer? (R)

        Mountain Dew
        Pepsi
        Coke
        Mello Yello
        Diet Coke
        Diet Pepsi
        Other

10.   Do you believe in ghosts? (R)

        Absolutely!
        Yes, I think so
        Not sure
        No, I don't think so
        Absolutely, not!
        Why do you want to know?
        I'm not allowed to tell you.

11.   What religion are you? (if any) (R)

        Christian
        Atheist
        Pagan
        Satanist
        Moslem
        Buddhist
        Other

12.   Have you ever been abducted by aliens? (R)

        Yes, many times
        Yes, a few times
        Yes, once
        I have no idea
        Nope, definitely not
        No, I don't think so
        I AM an alien

13.   What pet(s) do you have? (R)

        Cat(s)
        Dog(s)
        Any kind of rodent(s)
        Snake(s)
        Fish
        Other (or more than one of the above)
        None

14.   What is your marital status? (R)

        Single and looking
        Single and not looking
        Married
        Divorced
        Separated
        Living together
        Other

15.   Do you smoke cigarettes? (R)

        Yes
        No, but used to
        No, never did
        Tobacco? No.
        Sometimes
        Yes, heavily
        None of your business!

16.   Do you smoke pot?

        Yes, all the time
        Yes, occasionally
        Yes, rarely
        No, but I used to
        No, never have
        I refuse to answer
        Only when I'm drunk

17.   Which best describes your body type? (R)

        Super skinny
        Slender
        Average
        Chubby
        Voluptuous
        Fat
        Obese

18.   You can only eat one of the following foods for the rest of your life. Which do you pick? (R)

        Spinach
        Pizza
        Cheeseburgers
        Lasagna
        Tacos
        Tofu
        Snickers bars

19.   Which best describes your occupation? (R)

        Laborer/Factory worker
        Food service worker
        Cashier
        Health services
        Telemarkter/Bill collector
        Professional
        Other

20.   If you said "other" in the above question...which of the following best describes your occupation?

        Prostitute/Pimp
        Homemaker
        Day Care provider
        Scientist
        Slave
        Housekeeper
        Other

21.   If you said other for both of the above questions: Tell me what you do for a living!

     

22.   Do you drink alcohol? (R)

        Yes, everyday!
        Yes, regularly
        Yes, occasionally
        Yes, rarely
        No, but I used to
        No, never did
        What was the question?

23.   Have you ever done hard drugs? (R)

        Yes, cocaine or crack
        Yes, heroin
        Yes, hallucinogenics
        Yes, meth
        Yes, more than one of the above (or other)
        Yes, all of the above
        No!

24.   Are you afraid of death? (R)

        Yes, terrified
        Yes, a little
        No, not really
        No, not at all
        I'm immortal
        I'm religious, I look forward to death
        Other

25.   If you said "other" to the last question, please explain briefly how you feel about death and why.

     

26.   This survey allows the sending of Gift Points.
      You can give if you want!

      You currently have 0 Gift Points.
      Enter the number of Gift Points to be sent:
      Confirm this Gift Point amount by re-entering:
      (From a minimum of 100 to a maximum 250,000 Gift Points.)

Important: Gift Points included will be sent to Mrs. Penguin . Writing.Com will deduct a fee of 2.5% for processing the transaction for member. Gift Points sent through this form are not refundable for any reason. Please use good judgement when sending Gift Points to any member or group.

Disclaimer: The information that you are submitting with this survey form is being sent to Mrs. Penguin . It is NOT being sent to Writing.Com. You should be careful to not submit any information which you may deem as private or confidential. Writing.Com and its affiliates will not and may not be held responsible or liable, in any way, for any damages that may or may not arise from your submission of this form.