This Goal Contract takes 10-minutes to complete.

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* 1. Are you...

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* 2. How old are you?

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* 3. What grade are you in?

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* 4. Do you pledge to avoid using alcohol and drugs during the next 7 days in order to maintain an active and healthy lifestyle?

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* 5. Which one of the following healthy habits will you improve during the next 7 days? Chose one.

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* 6. List a specific, measurable healthy habit will you improve from the list above. For example, playing tennis is measurable but getting more exercise is not, and eating more fruits and vegetables is measurable but eating healthier is not.

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* 7. List an exact amount of that habit you will do each time. For example, 30 minutes each time, or 5 servings of fruits and vegetables each day.

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* 8. List an exact frequency of the habit you will do. For example, 4 days a week, Monday-Thursday, or each day of the week.

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* 9. In addition to yourself, who else will sign this goal plan to make it an official contract between you and them?

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* 10. Where will you post your goal plan/contract so you can see it every day and be reminded to monitor your health habits? Choose one.

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* 11. Add your signature and date below.

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* 12. Have your co-signer sign and date below.

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* 13. Congratulations! You have successfully completed the Prevention Plus Wellness Goal Contract. Remember to place this contract where it can be seen each day to monitor your daily goal progress. After one week, review your goal plan and complete another to help you continue to experience success in reaching your goals.

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* 14. You’ve taken the first and most important step toward improving your wellness. Improving yourself is a life-long process. It takes committing to small changes. Focus on and celebrate the small gains you make each day, week and month. You can do it! Keep trying. Never quit!

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* 15. What did you like BEST about the Prevention Plus Wellness lesson?  For example, how did it help you with your health habits, motivation, goal setting, self-esteem, etc.

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* 16. What did you like LEAST about the Prevention Plus Wellness lesson?  For example, what would you like to see changed or improved?

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* 17. PRINT OUT YOUR COMPLETED GOAL CONTRACT NOW. Then take it to be co-signed and dated by the person you identified above. Now, rate this Goal Contract experience.

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