‘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
‘raining, 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) lav, hon 7 ela
Project Topic Dmprer DUN Ce
Mentor Name
Place of Employment =>
Work Address) A In ce WC
Preferred Email. dO,
Preferred Phone :
Occupation / Title / Expertise Related to Topic_Vice £7
VI TE SOA eee
Tech Maraat ~ Coon
Years of experience in topic Sea 1 varars
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 tgthe best of spy ability. | also confirm that I am not related to the student.
me
Parent Signature dae P20. J,
signee Ma (Ay 2 pee ag
‘Mentor Signature