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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 wor 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__ OWA Thomas
Project Topic _ OYA MOAONITICL a
Mentor Name__ BY€Ht HNN
Plece of Employment HHil| Ortn@doOnt Cl. eRe
Work Address AIS Caldweli commons Civ. cornelius, Wo
Preferred Email OW\M@ W\VIG¥ FO. com
Preferred Phone 104 @%6 4502. ui
occupation / Title / Expertise Related t Tonic OA OAK St
Years of experience in topic area ONY XQ earo
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. [also confirm that I am not related to the student.
Mentor Signature Bucy a Date CY -1-11
Parent Signature i M- PRomas - Date_@ Jealz
Student Signature Ob ne rhawer pare 4/10/19