| Student Name (age) | Day 1 | Day 2 | Day 3 | Day 4 | Day 5 | Total |
| Studying | ||||||
| Leisure and Playing | ||||||
| In Class Time | ||||||
| Sleeping | ||||||
| Eating | ||||||
| Doing Familly Chores | ||||||
| Work (employment outside of the home) | ||||||
| Other activities | ||||||
| TOTAL HOURS | 24 | 24 | 24 | 24 | 24 | 120 |
| Identify your school and location here. | Student 1 | Student 2 | Student 3 | Student 4 | Student 5 | Total | Percent |
| Studying | |||||||
| Leisure and Playing | |||||||
| In Class Time | |||||||
| Sleeping | |||||||
| Eating | |||||||
| Doing Familly Chores | |||||||
| Work (employment outside of the home) | |||||||
| Other activities | |||||||
| TOTAL HOURS | 24 | 24 | 24 | 24 | 24 | 100% |