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The Questionnaire
Order Form (PDF)
Your Firstname :
Your date of birth in the format DD/MM/YYYY :
You are
Male
Female
Your age
more than 100 years
between 90 and 99 years
between 80 and 89 years
between 70 and 79 years
between 60 and 69 years
between 50 and 59 years
between 40 and 49 years
between 30 and 39 years
between 20 and 29 years
between 10 and 19 years
between 0 and 9 years
Children
You do not have children
You have children
Your continent of birth
Asia
Oceania
America
Africa
Europe
You usually dress
Shiny shoes
Trainers
Flannel Pyjamas
Relaxed style
No style in particular
The worst misery in France
To have no roof
To have no work
To have work ant not able t live decently
For which reason would you most easily make a donation
The protection of spiders
The increase of red lights
The reinsertion of daisies in town centres
The fight against annoying people
You like
Cindy Sherman
Jean-Michel Basquiat
Vermeer
Picasso
Gauguin
Michel Ange
Faith
You believe in a God
You don't believe in any God
The last time you cried was
From laughter or joy
During or at the end of a film
Worry
Pain
The loss of a close relative
Other
The epitome of success
Drinking champagne at lunch and in the evening
Confirming you are happy
Eating bio-veg from your garden
Being famous
Having a Swiss bank account
Having a car with gold plated alloy wheels
Being indebt to no one
The style of music you dislike
Classic
Rock n’ roll
Variety
Rap
Punk
Have you taken an AIDS test
Yes
No
Don’t wish to reply
Your priority for economising energy at home is
Brush you teeth every two days
Shower every two days
Pull the loo chain every second time
Turn out unused lights
Respect speed limits
You are not worried by this
You think a soldier is
A man in uniform
Someone who doesn’t understand
A hero
Your greatest disappointment
You wanted to stay single
You never feel disappointment
You failed an important exam
Do a job you hate
You have never experienced disappointment
Have forgotten to water your favourite rose
A civic gesture is
Not parking anywhere
Recycling
Voting
You watch television per day
More than 4 hours
Between 3 and 4 hours
Between 2 and 3 hours
Between 1 and 2 hours
Less than 1 hour
Not at all
Choose a shape
Egg
Moon
Empty Page
Choose one of the five senses
The buzz of a bee
The brushing past of a silk garment
The setting of the sun
Morning coffee
A sweet strawberry
You are addicted to
To drugs
To games
To sex
To alcohol
To the computer
To tobacco
To chocolate
To nothing in particular
Are you for euthanasia?
Yes
No
What score would you give yourself?
00/10
02/10
04/10
06/10
08/10
10/10
For an evening you prefer
Sex
Television
Cinema
Sport
An evening with friends
Do you own a mobile phone
Yes
No
Is it useless to
Put on perfume
Give a tip to your janitor
Change clothes each season
Sing in the shower
Weigh food
Talk to the flowers
For you 6 =
2 + 4
4 + 2
1 + 5
5 + 1
3 + 3
Eating is
A necessity
A pleasure
One word linked to childhood
Punishments
Sandcastles
Hugs
Sweets
Toys
Choose a vegetal element
Baobab
Poppy
You leave towards
East
West
North
South