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__ 34.50 a a
Project Topic
Mentor Name. =e Prosser
Place of Employment Te rd (ven
work Address 2020 SutteE Starity Rowd Chay He Ne 99206
Preferred Email S¢ nett+e —. prosser@ hotmai 2 Cam
Preferred Phone_7204-S77~O62Y
Occupation / Title / Expertise Related to Topic cect a L
‘Years of experience in topic area id
For the protection of myself and the student, J agree that we will not mect alone. I agree to uphold the
roles/duties ofthe project mentor to the best of my ability. I also confirm that I am not related to the student.
Mentor Signature _.
Parent Signature”
Student Signature