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Sample Behavior Contract 2

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									               Sample Behavior Contract
Name: ______________________________ Grade: __________________ Date: ___________________


Target Behaviors:
       1. ________________________________________________________________________________
       2. ________________________________________________________________________________
       3. ________________________________________________________________________________

Triggers that may lead to the behavior:
       1. ________________________________________________________________________________
       2. ________________________________________________________________________________
       3. ________________________________________________________________________________
       4. ________________________________________________________________________________

What I will do in order to cease the behavior:
      1. ________________________________________________________________________________
      2. ________________________________________________________________________________
      3. ________________________________________________________________________________
      4. ________________________________________________________________________________

Please Help Me!!! (Or what my teacher will do to help me)
       1. ________________________________________________________________________________
       2. ________________________________________________________________________________
       3. ________________________________________________________________________________
       4. ________________________________________________________________________________

Incentives:
       1. ________________________________________________________________________________
       2. ________________________________________________________________________________
       3. ________________________________________________________________________________

Expected Consequences:
      1. ________________________________________________________________________________
      2. ________________________________________________________________________________
      3. ________________________________________________________________________________


Signature & Date (student): _________________________________________________________________
Witness (teacher): _________________________________________________________________________




                                                             Sample Behavior Contract (older students)

								
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