Goal Getter Contract Worksheet
My Success Contract
A personal agreement to build positive habits and achieve my best
Goal Setting
Student Name:
Date:
Review Date:
1
My Power Goals (What I Promise to Practice)
Goal A: When working independently or with a group, I will:
Goal B: When transitions or classroom changes happen, I will:
2
My Reset Plan (When I Feel Stressed or Distracted)
Check 2–3 strategies that help you regain focus and calm down:
Take 5 deep breaths Ask for a 2-min break Use a fidget / calm tool Drink water / stretch Ask teacher for help Write down thoughts
My favorite personal strategy when I need to reset:
Celebration & Reward
When I meet my goals consistently, I earn:
If I Forget My Plan
Step 1: Gentle reminder. Step 2: Reset break. Step 3:
Our Success Pledge
"I am capable of reaching my goals. We agree to work together as a supportive team."
Student Signature
Teacher Signature
Parent / Guardian Signature
Weekly Goal Tracker
Daily reflections and milestone progress for my success contract
Daily Check-In
Week of:
Primary Focus Goal:
Daily Milestone Log Rate each day: ⭐ Crushed It • 👍 Good Effort • 🔄 Need Reset
| Day | Daily Effort | My Biggest Win or Highlight | Initials |
|---|
| Monday | | | |
| ⭐ 👍 🔄 | | | |
| | |
| Tuesday |
⭐ 👍 🔄
| | |
| Wednesday |
⭐ 👍 🔄
| | |
| Thursday |
⭐ 👍 🔄
| | |
| Friday |
⭐ 👍 🔄
| | |
3
End-of-Week Reflection
What went really well this week that I feel proud of?
What was tricky or challenging, and what strategy will I use next week?
Weekly Celebration Check:
Goal Reached • Reward Earned! Great Effort • Next Week is Ours
Mentor Initials: