Academic and Behavior Contract

Student Name:

Date:

Teacher Name:

Course:

1. Current grad in this class (grade & %) =

2. What is going well for the student in class?

Interventions and Contract

To receive a minimum passing grade in this course, student will need to complete the following:

All items must be turned in to teacher by this date:

Do you have any questions about any upcoming or past assignments(s)/test(s) that will help you complete your assignment(s) with more success?

What challenges do you think get in the way of your learning and being successful in class?

What is one DBT skill that will help you be successful in the classroom?

What way can the teacher help you use this DBT skill in the classroom?

Teacher agrees to

• Provide safe and comfortable learning environment
• Provide ample time for student to receive extra help in and after school
• Provide students with clear and concise expectations
• Work to make learning and enjoyable experience
• Enforce school rules consistently
• Use validation when connecting with student (ex: today seems like it’s a hard day)
• Help student identify what they need from teacher (ex: what part of assignment are you stuck on?)
• Restate what student says back to them (ex: it sounds like you know … skill/knowledge… but you aren’t sure how to … skill/knowledge…. Or you get stuck when you have to … skill/knowledge…)

Student agrees to

• Be respectful to all in the classroom
• Put my best effort into my school work
• Obey all rules in school and cottage
• Come prepared to school with homework and materials
• Turn in all homework and prepare for tests
• Attend all classes unless otherwise excused
• Take time-outs in the class setting