You are on page 1of 1
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 f 2 Project Topic ist Mentor Name Je¥S “Doce _ Place of Employment “Papo Lake “Reeuce ne Work Address /O4 Yellow Wonk Cire le Preferred Email \e SF laoee @ pine Lele pre 2% Preferred Phone 70-23. 7- S368 Occupation / Title / Expertise Related to Topic_ecchec 7 werks bh ishee = Years of experience in topic area__! 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 mentor to the best of my ability. I also confirm that I am not related to the student, Mentor Signature ©) ¢ ff. a Date_//2s/ Parent Signature cafe Date 2/9 {1 4 Student Signature Wed, =. Date | jig

You might also like