Appendix C

Mentor Consent Form form' the

The role of the Mentor is to serve as an expert
in thrc field chosen by the student' By signing this
into the
mentor agrees to: allocate time (a of rcn Uo*'f io work with the student; provide insight
*l"t**;
that the student is actively involved during shadowing
training, expectations, and demands of the field; ensure the
and not simply observing. If desired, the mentor
may provide suggestions' advice' and support regarding
development of a tangible product that connects to the
real-world requirements of the career'

Student Name Grimmius

Project Topic Film

Mentor Name John

Place of Employment

Work Address

Preferred Email

Preferred Phone 9to-L9o -/362

Occupation /'title / Expertise Related to Topic ;t.
ri I,u\
r" r
Years of experience in topic area €r

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 to my ability. I also confrm that I am not related to the student.

Mentor Signature Date ,-2(-/?

Parent Signature Date

Student Signature Date