I have intentionally left this activity completely blank so that it will fit your needs!
Here's how I use it: My 1st grade students get to make a schedule for their ideal day. They show the time both ways, and then write a sentence describing what they would be doing at that time.
Example
10:00am: I wake up and eat ice cream for breakfast.
11:30am: Andrew invites me to his house and we play video games.
1:00pm: My grandparents take me to Chuck-E-Cheese for lunch, then we go ride roller coast