Self Discipline Card 

WRITE DOWN SOMETHING YOU DID AROUND THE HOUSE OR AT SCHOOL

THAT YOU DID NOT HAVE TO BE TOLD TO DO BY YOUR PARENTS OR

TEACHERS. BE CREATIVE! ALSO, WRITE DOWN EACH TIME YOU STOPPED

YOURSELF FROM DOING SOMETHING YOU KNOW YOU SHOULDN’T.

                                                                        Write on the back of the card the things you did.

Student Name:_________________________________________

1. 2. 3. 4. 5.
6. 7. 8. 9. 10.

Instructor Signature/Date:______________________________________________

Parent Signature/Date:_________________________________________________
1. 2. 3. 4. 5.
6. 7. 8. 9. 10.

Instructor Signature/Date:______________________________________________

Parent Signature/Date:_________________________________________________

 
1. 2. 3. 4. 5.
6. 7. 8. 9. 10.
         

Instructor Signature/Date:_______________________________________________

Parent Signature/Date:__________________________________________________

HOME