Physical Activity Promotion Assignment

Do you feel that you get as much exercise as you need, or less than you need?

1. As much as needed

2. Less than needed

how often do you exercise?

I am physically active for at least 30 minutes every day.

Do you do any of these exercises on a regular basis – If “Yes,” circle appropriate letter.

A. Ride bicycle

B. Jog

C. Lifts Weights

D. Swim

E. Walk For Excercise

F. Do you do any other exercise on a regular basis?

Would you say that you are physically more active, less active, about as active as other persons your age? Please tick the right Option.

1. More active

2. Less active

3. Same

4. Other (specify)__________________________

How old are you?

15-20 years

20-25 years

25-30 years

30-35 years

Why did you stop stop participating in physical activity? please tick the right answer.

	Drag your choices here to rank them
No time No interest No Embarrassed No Unmotivated Too expensive Other

Do you follow a REGULAR routine of physical exercise?

1. Yes

2. No

In your opinion which of these are the TWO best ways to lose weight?

1  Don’t eat at bedtime

2  Eat fewer calories

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