Mentor Consent F o r m

The r o l e o f t h e M e n t o r is to serve as a n expert i n t h e f i e l d chosen by t h e s t u d e n t . By

s i g n i n g t h i s f o r m , t h e m e n t o r agrees t o : allocate t i m e (a m i n i m u m o f t e n hours) to w o r k
w i t h t h e s t u d e n t ; p r o v i d e i n s i g h t i n t o t h e t r a i n i n g , expectations, a n d demands o f t h e f i e l d ;
ensure t h a t t h e s t u d e n t is actively i n v o l v e d d u r i n g s h a d o w i n g a n d n o t s i m p l y observing. I f
desired, t h e m e n t o r m a y p r o v i d e suggestions, advice,
and support regarding the
d e v e l o p m e n t o f a t a n g i b l e p r o d u c t t h a t connects t o t h e r e a l - w o r l d r e q u i r e m e n t s o f t h e
career.

Student N a m e - A l i v i a W e d d i n g t o n
Project Topic- Cosmetic

surgery

Mentor N a m e
Place o f E m p l o y m e n t
W o r k Address
Preferred E m a i l
P r e f e r r e d Phone
O c c u p a t i o n / Title / Expertise Related t o Topic .

Years o f experience i n t o p i c area

I 5^ J h^^'^^ .

For t h e p r o t e c t i o n o f m y s e l f a n d t h e s t u d e n t , I agree t h a t w e w i l l n o t m e e t alone. I agree t o

u p h o l d t h e roles/duties o f t h e w ^ e c t m e n t o r t o t h e best o f m y a b i l i t y . I also c o n f i r m t h a t I
a m n o t r e l a t e d to t h e s t u d e n t / ^ /
.
,
/
Mentor S i g n a t u r e
Student S i g n a t u r e

.^-^

^ P > - -

Date

A //

( ' '

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