DECLARATION OF MENTORING COMPLETION FOR PIERCE COUNTY SUPERIOR COURT PARENTING INVESTIGATOR/GUARDIAN AD LITEM REGISTRY -- RCW 26.09 I declare under penalty of perjury, under the laws of the State of Washington, that the following information is true and correct. All Declarations are due in Superior Court Administration by: December 31, 2010, 4:30 p.m. As required for qualification for the registry for Pierce County Superior Court Parenting Investigators and Guardians ad Litem in parenting cases, I have completed and satisfied the requirements of mentoring and education as follows: __________________________________________ Applicant’s Name I am exempt, please attach copy of exemption letter. (Check Box) __________________________________________ Mentor’s Name Yes / No Journal entries reviewed by Mentor ___________Hours of Mentoring (Total) ___________Hours of Job Shadowing (Total) Please describe information covered during your mentoring sessions and time spent in detail: Attach additional pages if necessary. (Example Initial meeting with Mentor, review of rotational drawl and retainer payment procedures .75 hours) ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ -1American LegalNet, Inc. www.FormsWorkFlow.com DECLARATION OF MENTORING COMPLETION FOR PIERCE COUNTY SUPERIOR COURT PARENTING INVESTIGATOR/GUARDIAN AD LITEM REGISTRY -- RCW 26.09 (Continued) Please summarize from your job shadow journal information learned during your job shadowing sessions. (Attach additional pages if necessary) ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ Please print any and each training session that you have attended below. ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ Additional training sessions will be scheduled in the near future. __________________________________________ Applicant’s Signature Date __________________________________________ Mentor’s Signature Date -2American LegalNet, Inc. www.FormsWorkFlow.com