Appendix C
Mentor Consent Form
The role of the Mentor is to serve as an expert in the field chosen by the student. By signing this form, the
mentor agrees to: allocate time (a minimum of ten hours) to work with the student; provide insight into the
training, expectations, and demands of the field; ensure that the student is actively involved during shadowing
and not simply observing. If desired, the mentor may provide suggestions, advice, and support regarding the
development of a tangible product that connects to the real-world requirements of the career.
Student Name WiEL TUR
Project Topic
Mentor Name C3 AY ROMIBEAG
Place of Employment A] ER OBYR Wily ~TUAsn/erk
Work Address_ | BS G0 SPE; PE
Prefered Email 4 P TACMA CLO (QD E/PAllLg COrg
Preferred Phone “OY ¢Y9- EPID
Occupation / Title / Expertise Related to Topic _2= carve
Years of experience in topic area_ 5B
For the protection of myself and the student, I agree that we will not meet alone. I agree to uphold the
roles/duties of the projectthentor Ie, ability. | also confirm that | am not related to the student,
Mentor Signature
Parent Signature Date
Student Signature Date