Here's a simple template for personal goal setting. I have designed the form using MS Office Infopath. The recurring table is designed to add any number of rows as you wish. You can enter a single symbol either a tick mark or cross, in the final DONE field. It will only allow you to save each file as a form in which you can enter values. If you wish to customize the template, tweak it as you wish by opening it in design mode. Have fun!
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Google docs: Goal Setting Template