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
Tenior ABrees to; allocate time (a minimum of ten hours) to work with the student; provide insight fate the
ing, expectations, and demands of the field; ensure that the student is actively involved during shadowing
ea not simply observing. If desired, the mentor may provide suggestions, advice, and support regarding the
levelopment of a tangible product that connects to the real-world requirements of the career.
Student Name Hunter Kibo
Project Topic _ Op tometcu,
Dr Mereditn HackWy
Mentor Name
Place of Employment Secdiwm Se Care
Work Address_119. Landing s Dive, Ste LS Moniesite, NG 23h
Preferred Email_ dy hacHeY@spectwmneye (Ove Ne.com
Preferred Phone_7OY- $1} -4000
Occupation / Title / Expertise Related to Topic_ Optornctust
Years of experience in topic arca__ 3 EQNS
For the protection of myself and the student, I agree that we will not meet alone, I agree to uphold the
soles/duties of the project mentor to the best of my ability. I also confirm that I am not related to the student.
Mentor Signature DM. Hetbhag Date 09] she
Parent Signature ain) Date y / Fiy
sindent Signature Hone hthadh ~ pate IAA /16