Student Behavior Contract Template

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M Y C O N T R A C T
I _________________________________________________ agree to the following terms:
These are my goals:
1. _______________________________________________________________________________________
Threshold: _______________________________________________________________________________
2. _______________________________________________________________________________________
Threshold: _______________________________________________________________________________
These are my rewards/reinforcers if I meet my goals:
_________________________________________________________________________________________
_________________________________________________________________________________________
_________________________________________________________________________________________
These are my consequences if I do not meet my goals:
_________________________________________________________________________________________
_________________________________________________________________________________________
_________________________________________________________________________________________
My contract will be reviewed on ___________________________________________________________
Signatures
Student _____________________________________________ Date _____________________________
Teacher ______________________________________________ Date _____________________________
Parent _______________________________________________ Date _____________________________
Parent _______________________________________________ Date _____________________________

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