Page 1

INSTRUCTIONS: Arbitrarily decide on a day to do this assignment. Select a day when you will be interacting with a variety of people. Record one instance in which you initiated a touch and one instance in which you were touched. If you feel the touch you initiated was unnatural (prompted by this assignment), wait and record one you think occurs more spontaneously. DUE:  October 14, 1999.

1. Interactants:

• Gender Composition (circle): M/M F/F M/F
  
• Familiarity w/each other (circle): Not at all 1 2 3 4 5 6 7 Very Familiar
  
• Age of Pair (circle): Within 1-2 yrs. / 2-5 yrs. / More than 5 yrs. difference in age of each other
  
• Status (circle): Each about the same/ Touch Initiator Higher/ Touch Recipient Higher
  
• Cultural Background (circle): Pretty much the same/ Somewhat different/ Very different

2. Body Area(s) Touched: _________________________________________________________________________________________

3. Manner of Touch (e.g., pat, pinch, stroke, slap, etc.) ____________________________________________

4. Meaning of Touch (to you): _________________________________________________________________________________________

5. Verbalizations Accompanying Touch (if any): _________________________________________________________________________________________

6. Other's Reaction to the Touch: _________________________________________________________________________________________

7. Where Touch Took Place (circle): Private 1 2 3 4 5 6 7 Public

8. Other Observations:




__________________________
Observer's Name (print)

_________________________
Observer's Social Security #


Please complete page 2



Page 2

1. Interactants:

• Gender Composition (circle): M/M F/F M/F
• Familiarity w/ each other (circle): Not at all 1 2 3 4 5 6 7 Very Familiar
• Age of Pair (circle): Within 1-2 yrs. / 2-5 yrs. / More than 5 yrs. difference in age of each other
• Status (circle): Each about the same/ Touch Initiator Higher/ Touch Recipient Higher
• Cultural Background (circle): Pretty much the same/ Somewhat different/ Very different

2. Body Area(s) Touched: ____________________________________________________________________________________

3. Manner of Touch (e.g., pat, pinch, stroke, slap, etc.) _______________________________________

4. Meaning of Touch (to you): ____________________________________________________________________________________

5. Verbalizations Accompanying Touch (if any): ____________________________________________________________________________________

6. Other's Reaction to the Touch: ____________________________________________________________________________________

7. Where Touch Took Place (circle): Private 1 2 3 4 5 6 7 Public

8. Other Observations:



________________________________
Touch Initiator's Name (print)

___________________________________
Social Security Number of Initiator


Please staple pages 1 and 2 together before turning in.