Behavior Contract Template

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Behavior Contract
Contract between ______________________ and ____________________ Date________
(student)
(teacher)
Description of behavior problem:
Description of desired behavior:
Plan for behavior change:
Rewards for contract:
Consequences for contract:
Monitoring and Evaluation of contract:
Comments:
Signed:______________________________________ date:__________________
(student)
Signed:______________________________________ date:__________________
(teacher)
Signed:______________________________________ date:__________________
(parent/guardian)
Copies to:
______________________________________________________________
______________________________________________________________
Behavior Contract
Contract between ______________________ and ____________________ Date________
(student)
(teacher)
Description of behavior problem:
Description of desired behavior:
Plan for behavior change:
Rewards for contract:
Consequences for contract:
Monitoring and Evaluation of contract:
Comments:
Signed:______________________________________ date:__________________
(student)
Signed:______________________________________ date:__________________
(teacher)
Signed:______________________________________ date:__________________
(parent/guardian)
Copies to:
______________________________________________________________
______________________________________________________________

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