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 SG Chovealte—
Project Topic
Mentor Name_ Mary She phous
Place of Employment The Liak Gro 42
Work Address 17S 44 igo te De a SS
Preferred Email_ atu @ Hg -cona
Preferred Phone (20 —G1$-4 DES
‘Occupation / Title / Expertise Related to Topie_Researcln Manages : Word at
1 i Sy Af A CO pans
Years of experience in topic area__ A+
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 fo the best of my ability. also confirm that I am not related to the student.
Mentor Signature Ww a — pate F-1f- If
Date
Student Signature ___ Date