Homework/School Contract

I, _______________________________, understand this contract is being created due to my problem completing my school work in an acceptable manner and time.   I understand that my parent (s) has agreed to this contract to help motivate me to be responsible with my school work.  To prevent experiencing the consequences outlined in this contract, I understand I must improve my school performance in all areas.

  Privileges I Enjoy (check all that apply)

I understand privileges are given to me by my parent(s) for appropriate behavior and can be removed by my parent(s) if I do not due to my inappropriate behavior.  The following things are privileges I enjoy:

q       Watching Television

q       Watching favorite TV Shows or Sports

q       Having a television in my room

q       Playing Video Games

q       My parents giving me money to go to the movies with my friends

q       My parents giving me extra money to buy a special food or snack at school lunch

q       Renting a new video at the video store for Friday or Saturday night

q       Playing with friends          

q       _________________________________________

q       _________________________________________

q       _________________________________________

Parent Agreement

  I/we agree to respectfully enforce the contents of this contract for my/our child in an attempt to motivate him/her to improve overall school performance.  I/we agree to make every attempt to ensure the consequences are appropriate to the problem noted.   I/we further understand consequences without time-limits will decrease the effectiveness of  this contract, and all consequences should include a time-limit. (i.e., “TV removed from room for one week.”

Signatures

I, _________________________, agree to follow this contract as of this date.

__________________________________________               ___________________

Student Signature                                                                       Date

__________________________________________               ___________________

Parent Signature                                                                         Date

__________________________________________               ___________________

Parent Signature                                                                         Date

__________________________________________               ___________________

Counselor Signature                                                                   Date

__________________________________________               ___________________

Teacher Signature                                                                       Date