Appendix 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 xO Project Topic _A\ 2 ince Mentor Name COL nr Place of Employment COM is’ SOCi Work Address 12.05 Kiniginis br dog, De Womlboriige, VA 22142 Preferred Email _QO} in C Preferred Phone (OWH) - 2.13 - SO%G Occupation / Title / Expertise Related to Topic MACY) Ager oy CONSUL Hng. Wem N_E nm. Se Years of experience in topic area OVA\" 2. pcs 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 project mentor to the best of my ability. I also confirm that [ am not related to the student. Mentor Signature Ohl J Date ld /evll e D /} Parent Signature bo Wl Date_G//2, 2, Student Signature Mas Date Z ‘Materials in this handbook are derivatives of the copyrighted material owned and created by the Partnership for Dynamic Learning in Davidson, North Carolina. Reprinting, copying, or republishing this handbook in any form is not allowed ‘except by permission from P4DL. 23