KC@Home Leisure Interest Survey for Applicant
Name
First Name
Last Name
Date
-
Month
-
Day
Year
Date
I enjoy these nature activities. (please specify more detail under other)
Gardening/Yard Work
Nature study
Following the weather
Exercising outdoors
I enjoy games. (please specify more detail under other)
Chess/Checkers/Cards
Paper Pencil Puzzles/Trivia
Puzzles
Computer games
Outdoor games
I like to watch these sports. (please specify more detail under other)
Baseball
Football
Basketball
Olympics
Tennis
I enjoy participating in these sports. (please specify more detail under other)
Winter
Spring
Summer
Fall
I enjoy music. (please specify more detail under other)
Playing an instrument
Listening/Watching
Singing
I enjoy literature. (please specify more detail under other)
Poetry
Writing
Reading
I enjoy crafts. (please specify more detail under other)
Creating
Viewing
I enjoy art. (please specify more detail under other)
Creating
Viewing
I enjoy traveling. (please specify more detail under other)
Domestic
International
I enjoy keeping up with current events. (please specify more detail under other)
Politics
Newspaper
Radio
Television
Computer
I exercise. (please specify more detail under other)
Walking
Seated exercise
Personal trainer
Going to the gym
Swimming
I enjoy going out. (please specify more detail under other)
Restaurants
Cultural events
Educational events
Parties
Family events
I maintain religious/spiritual practices. (please specify more detail under other)
Church
Synagogue
Temple
Mosque
I enjoy these other hobbies not mentioned above.
I have a pet.
I collect these things.
I really don't like...
Three things I would really like to participate in at Kensington Club@Home.
Here is some extra information about me that will help you get to know me.
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