Student Goals Contract

Student Goals Contract

I (Name) _____________________________________ agree to work on accomplishing the following goals. I realize that the resulting outcomes will be a direct result of my own personal efforts. I also realize that this Student Goals Contract may be revised at anytime.

The student agrees to the following:

Attendance expectations:

1. I will wake up at _______ on school days.

2. I will attend every class on time daily with a positive attitude.

3. I will miss school only when I am sick, and I will bring a note to excuse my absence.

Behavior and Life Skills expectations:

1. I will treat everyone, including students, teachers and principals with the respect that I would like to be treated with.

2. I will follow all school rules.

3. I will follow healthy advice and work on changing unhealthy physical and mental habits.

4. I will actively engage in discovering my talents and passions so that I can find the right secondary education, career and be a happy, healthy, well rounded person?

Academic expectations: (No F Game Plan- Guaranteed at least a D if you do these things.)

1. I will go to every class on time and stay on task and awake focusing on the lesson.

2. I will complete all my work to the best of my ability and turn it in. (Ask for help on assignments when I need it, so there will be no incomplete work.)

3. I will study for tests.

The CIS staff agrees to the following:

1. Provide support and guidance for the above indicated issues. To be here for you.J

2. Meet with you regularly to make sure there is progress.

3. Check with your teachers and other staff to make sure there is progress.

Student Signature: ______________________________________Date: _____________________

CIS staff Signature: _____________________________________ Date: _____________________

Intake Questionnaire/Student Goals Contract

About the student:

1. What do you like to do when you’re not in school?

2. What is something that your teachers may not know about you that you’d like to share?

3. What are some of your strengths, or what you’re good at?

4. Who is someone you can count on for support?

5. Tell me about your family:

About the student’s school experience:

6. What is your favorite class? Why?_______________________________________________________

7. What is your least favorite class? Why?

9. In school, what do you have the most trouble with?

10. What helps you with your schoolwork?

11. For each of the following behaviors, tell me “yes” if you do it or “no” if you do not. (Y or N)

___ Attend school every day ___ Keep an assignment book or agenda ___ Ask questions

___ Pay attention in class ___ Complete all class work ___ Take notes

___ Complete all homework on time ___ Study for tests

Student Goals:

15. What are some of your goals for this year and the future?

16. How will you reach these goals?

17. What is your career goal?

18. What education do you need? 4-year college / 2-year college / technical or trade school / no further education / don’t know (circle one)

What do you need help with? Circle all that apply.

· Coming to school or being on time or both.

· Study skills and organizational habits?

· Passing classes?

· Relationships?

· Learning how to cope in healthy ways when life is hard?

· Figuring out your talents and passions so that you can find the secondary education and career that fits you? (What’s your purpose?)

CIR 2013