MEDIATION MENTORING PROGRAM APPLICATION
Thank you for expressing an interest in The Congress of Neutrals’ Mediation Mentoring Program. The entire Application process requires the following four steps:
STEP ONE (Paperwork and Deposit): Fill out the Application below and return it to the Congress of Neutrals via email or U.S. Mail. Submit a non-refundable pre-registration fee of $50 and email a copy of your current resume for our review. Payment may be made online using the link below (Select MMP Non-refundable Pre-registration Deposit Option in the PayPal menu below) or by check mailed and made payable to “The Congress of Neutrals.” (See Contact Information below).
STEP TWO: Wait for a call or email from our MMP Coordinators to schedule an interview and to discuss mediation training options.
STEP THREE: After the interview and upon acceptance into the program, pay the $550 balance using the link below (Select MMP Payment Balance Option in the PayPal menu below) or by check mailed and made payable to “The Congress of Neutrals.” (See address below).
STEP FOUR: We will set up a schedule with you and your mediation mentor at a branch court. This will include a six session mediation training to include: an orientation as to protocols and court-required forms prior to the court’s calendar, shadowing the mediations with your mediation mentor; co-mediating with the mediation mentor, trainee-led mediations with the mentor observing and post-mediation discussion between you and your mentor.
Fees: Non-refundable pre-registration fee $50.00
Registration Fee: $550.00
Total Fees for MMP Program: $600.00
Email Address: email@example.com
Mailing Address: 1390 Willow Pass Road, Suite 190, Concord, CA 94520
MEDIATION MENTORING PROGRAM APPLICATION (Please Print)
2. Street: _________________________________________
3. City: ________________________ 4. State/Zip Code: ______________________________
5. Cell: ________________________ 6. Work Phone: ________________________________
7. Email Address: _____________________________________
8. Employer/School/Organization (if applicable): _____________________________________
9. Professional or vocational licenses or certificates: ____________________________________
10. List your mediation experience as a party or mediator: ________________________________
11. I certify that I have successfully completed ______________ hours of mediation skills training as follows:
12. Name of Trainer/Provider:_______________________________________________________
NOTICE: The Congress of Neutrals requires a minimum of 25 hours of training (or equivalent experience), which meets the requirements of the California Dispute Resolution Practices Act of 1986. Our program allows ONLY facilitative-style mediation. No neutral assessment and no evaluative style mediations are permitted. No legal advice may be given.
Date: __________________ Signed: ___________________________________________