Appendix C Mentor Consent Form ‘The rale 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 cannects to the real-world requirements of the career. Student Name / =n) Cun Rat rey kn 4 Project Topic [iced dialo. a. J Mentor Name Faredipie , ents Ube Bre Place of Employment Su -at'@e Work Address gag Aatieate Hay Hantateles Prefered Email —pestelaee peli Al S0.EDU Preferred Phone 709 - £50)-Se4/P Occupation / Title / Expertise Related to Topic 7? ro fessor dey trou! tore ‘Years of experience in topic area 3S For the protection of myself and the student, I agree that we will not meet alone. | agree to uphold the roles/duties of the project re to the best of my ability. also confirm that [ am not related to the student. Mentor Signature ult el Date 5-89. /f om Parent Signature Z Le PS rs Date ~? Sax Is. Student Signature Ailey icp mie H-AaHK, ‘Materials in this handbook are derivatives of the copyrighted material owned and created by the Partnership for Dynamic Learning in Davidsen, North Carolina. Reprinting, eepying, or republishing this handbook in any form is not allowed ‘except by permission from PADL. 22