Recalling My Past – Memoir Worksheet

 

My Name: _________________________  Telephone #:_________________

Some idea helpers of past experiences or occurrences that you might enjoy recalling or that my children or grandchildren might like to hear about follow:
                                  

Events I recall Holiday times School memories Farm living and farm work Pets and/or Farm Animals Occurrences when I was young.

Home life Neighbors I remember Weather / Season I recall How Glen Elder used to be How / Where I used to play Friends I had and things we did

 

1) The Memory / Experience I want to write about is: __________________________________

 

2) I was ___________ years old when the experience occurred. 

 

3) What year season (approximately) did the experience take place?  _______________

 

4) What time of year did the experience take place? _________________

5) Where did the experience take place? (Be specific, include location, directions, landmarks…)
 

6) Who/what shared the experience with you?(Name names of friends, family, pets, animals…)

7) How/ why was the experience special to you?

6) Describe the Experience:  (BE SPECFIC!  What exactly happened?  What did you see, hear, feel and taste?  Why was it fun? Why was it not fun? Did it make you happy or sad? Was it pleasing, or not?, Etc.)

 

 7) When the experience took place I (my family) was living  (describe exact location).

8) My parent’s names are: _____________________________________________________

9) My brothers & sisters names are: ______________________________________________

10) Other Information: ________________________________________________________

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