Behavior Contract #3005


Name:_______________________________________________________ Date:____________________________

Use this behavior contract to set goals for yourself and earn rewards and privileges.


BEHAVIOR CONTRACT

I, _____________________________ (child's name), do hereby declare that I will:

__________________________________________________________________________

__________________________________________________________________________


I, _____________________________ (teacher or parent), do hereby declare that in exchange for

_________________________________
(child's name) fulfilling his/her promise as stated above, I will

___________________________________________________________________________.



In WITNESS WHEREOF, we have subscribed our names on this date.



Date:___________________________________________

Child's signature:________________________________

Teacher's/parent's signature:__________________________

Witness signature__________________________________

Adapted from Attention Deficit Accommodation Plan for Teaching (ADAPT) by Parker. Specialty Press, Inc. All rights reserved. This form may be copied for use in your practice.