Leisure Diary 3 Submission
Leisure Diary Form
Type of Activity:
|_| Arts/Crafts |_| Movie |_| Running
|_| Boating |_| Painting |_| Shopping
|_| Camping |_| Photograph |_| Swimming
|_| Cycling |_| Picnic |_| Volunteer Service
|_| Dining |_| Playing a Musical Instrument |_| Walking
|_| Fishing |_| Reading |_| Water sports
|_| Hiking |_| Roller-skating |_| Working Out
Length of time:
|_| 5 – 30 minutes |_| 31 – 60 minutes |_| 90 minutes |_| 120 minutes |_| 180 minutes |_| More than 200 minutes
Associated Costs: |_| No charge |_| $ 1 – 10.00 |_| $11 – 20.00 |_| $21 – 30.00
|_| $31 – 40.00 |_| More than $50.00
Please describe how you feel about your choices (not what you did)
-----------------------------------
Tuesday Date:
Type of Activity:
|_| Arts/Crafts |_| Movie |_| Running
|_| Boating |_| Painting |_| Shopping
|_| Camping |_| Photograph |_| Swimming
|_| Cycling |_| Picnic |_| Volunteer Service
|_| Dining |_| Playing a Musical Instrument |_| Walking
|_| Fishing |_| Reading |_| Water sports
|_| Hiking |_| Roller-skating |_| Working Out
|_| Other
Length of time:
|_| 5 – 30 minutes |_| 31 – 60 minutes |_| 90 minutes |_| 120 minutes |_| 180 minutes |_| More than 200 minutes
Associated Costs: |_| No charge |_| $ 1 – 10.00 |_| $11 – 20.00 |_| $21 – 30.00
|_| $31 – 40.00 |_| More than $50.00
Please describe how you feel about your choices (not what you did)
Wednesday Date:
Type of Activity:
|_| Arts/Crafts |_| Movie |_| Running
|_| Boating |_| Painting |_| Shopping
|_| Camping |_| Photograph |_| Swimming
|_| Cycling |_| Picnic |_| Volunteer Service
|_| Dining |_| Playing a Musical Instrument |_| Walking
|_| Fishing |_| Reading |_| Water sports
|_| Hiking |_| Roller-skating |_| Working Out
|_| Other
Length of time:
|_| 5 – 30 minutes |_| 31 – 60 minutes |_| 90 minutes |_| 120 minutes |_| 180 minutes |_| More than 200 minutes
Associated Costs: |_| No charge |_| $ 1 – 10.00 |_| $11 – 20.00 |_| $21 – 30.00
|_| $31 – 40.00 |_| More than $50.00
Please describe how you feel about your choices (not what you did)
-----------------------------------
Thursday Date:
Type of Activity:
|_| Arts/Crafts |_| Movie |_| Running
|_| Boating |_| Painting |_| Shopping
|_| Camping |_| Photograph |_| Swimming
|_| Cycling |_| Picnic |_| Volunteer Service
|_| Dining |_| Playing a Musical Instrument |_| Walking
|_| Fishing |_| Reading |_| Water sports
|_| Hiking |_| Roller-skating |_| Working Out
|_| Other
Length of time:
|_| 5 – 30 minutes |_| 31 – 60 minutes |_| 90 minutes |_| 120 minutes |_| 180 minutes |_| More than 200 minutes
Associated Costs: |_| No charge |_| $ 1 – 10.00 |_| $11 – 20.00 |_| $21 – 30.00
|_| $31 – 40.00 |_| More than $50.00
Please describe how you feel about your choices (not what you did)
Friday Date:
Type of Activity:
|_| Arts/Crafts |_| Movie |_| Running
|_| Boating |_| Painting |_| Shopping
|_| Camping |_| Photograph |_| Swimming
|_| Cycling |_| Picnic |_| Volunteer Service
|_| Dining |_| Playing a Musical Instrument |_| Walking
|_| Fishing |_| Reading |_| Water sports
|_| Hiking |_| Roller-skating |_| Working Out
|_| Other
Length of time:
|_| 5 – 30 minutes |_| 31 – 60 minutes |_| 90 minutes |_| 120 minutes |_| 180 minutes |_| More than 200 minutes
Associated Costs: |_| No charge |_| $ 1 – 10.00 |_| $11 – 20.00 |_| $21 – 30.00
|_| $31 – 40.00 |_| More than $50.00
Please describe how you feel about your choices (not what you did).
-----------------------------------
Saturday Date:
Type of Activity:
|_| Arts/Crafts |_| Movie |_| Running
|_| Boating |_| Painting |_| Shopping
|_| Camping |_| Photograph |_| Swimming
|_| Cycling |_| Picnic |_| Volunteer Service
|_| Dining |_| Playing a Musical Instrument |_| Walking
|_| Fishing |_| Reading |_| Water sports
|_| Hiking |_| Roller-skating |_| Working Out
|_| Other
Length of time:
|_| 5 – 30 minutes |_| 31 – 60 minutes |_| 90 minutes |_| 120 minutes |_| 180 minutes |_| More than 200 minutes
Associated Costs: |_| No charge |_| $ 1 – 10.00 |_| $11 – 20.00 |_| $21 – 30.00
|_| $31 – 40.00 |_| More than $50.00
Please describe how you feel about your choices (not what you did)
Sunday Date:
Type of Activity:
|_| Arts/Crafts |_| Movie |_| Running
|_| Boating |_| Painting |_| Shopping
|_| Camping |_| Photograph |_| Swimming
|_| Cycling |_| Picnic |_| Volunteer Service
|_| Dining |_| Playing a Musical Instrument |_| Walking
|_| Fishing |_| Reading |_| Water sports
|_| Hiking |_| Roller-skating |_| Working Out
|_| Other
Length of time:
|_| 5 – 30 minutes |_| 31 – 60 minutes |_| 90 minutes |_| 120 minutes |_| 180 minutes |_| More than 200 minutes
Associated Costs: |_| No charge |_| $ 1 – 10.00 |_| $11 – 20.00 |_| $21 – 30.00
|_| $31 – 40.00 |_| More than $50.00
Please describe how you feel about your choices (not what you did)