<p> WMDS PBS CONSENT FORM</p><p>Waynesville Middle School (WMDS) Positive Behavior Support (PBS) 2014-2015 Program Guidelines</p><p>The purpose of the Positive Behavior Support Program (PBS) is to teach, encourage, recognize and reward good decision-making and positive behavior for our middle school students. The following is an overview of our program. Please read the information and sign the form at the end of the document so your child is eligible to participate in incentives that will take place throughout the school year. All forms need to be turned in to the guidance office in order for the student to attend the activities the remainder of the year. For future reference you may also access the district website: http://www.waynesville.k12.mo.us/Domain/10</p><p>GOALS  To reduce the amount of instructional time lost due to behavioral issues  To promote good character among our students  To recognize positive behavior as opposed to the expected recognition of poor behavior</p><p>CRITERIA Quarterly and semester incentives will be available to participating students who meet the eligibility requirements for each grading period.  No detentions  No Saturday School  No In-school (ISS) or Out-of-School (OSS) Suspensions  No loss of bus or library privileges  No more than 2 unexcused absences per quarter</p><p>Quarterly Positive Behavior Activities At the end of each quarter students who meet eligibility criteria during the qualifying dates will be able to participate in a social/game/movie day that will take place in the building during school hours. Celebration dates are tentative.</p><p>1st quarter qualifying dates: August 21-October 15, 2014 1st quarter activity date: October 17, 2014</p><p>2nd quarter qualifying dates: October 16-Dec 19, 2014 2nd quarter activity date: January 9, 2015</p><p>3rd quarter qualifying dates: January 12-March 13, 2015 3rd quarter activity date: March 13, 2015</p><p>4th quarter qualifying dates: March 23-May 20, 2015 4th quarter activity date: May 20, 2015</p><p>Semester Positive Behavior Activities: Towards the end of each semester students who meet eligibility criteria during the qualifying dates will be able to participate in an off-campus outing during the school day. Activities may include field trips to a movie, skating, bowling, Springfield Cardinals games, STL Zoo etc. Specific dates for the semester activities have not yet been confirmed, but information will come home in advance if your child qualifies. 1st semester qualifying dates: August 21-December 18, 201 2nd semester qualifying dates: January 12-May 6, 2015 I acknowledge that I have read the WMDS PBS Guidelines, and understand that my child, ______, must meet the eligibility criteria for each activity that is set forth in the program in order to participate in the activities. WMDS PBS CONSENT FORM</p><p>______Parent signature Date</p><p>I acknowledge that I have read the WMDS PBS Guidelines, and understand that I, ______, must meet the eligibility criteria for each activity that is set forth in the program in order to participate in the activities.</p><p>______Student signature Date</p><p>4th Hour Teacher:______</p>