Free Mediator Application - District of Columbia

DISPUTE RESOLUTION PROGRAMS

UNITED STATES COURTS
DISTRICT OF COLUMBIA CIRCUIT
Jill C. Sayenga Circuit Executive Nancy E. Stanley, Director Michael A. Terry, Deputy Director

MEDIATOR APPLICATION FOR THE UNITED STATES DISTRICT COURT Eligibility Requirements: You must be admitted to the bar in any jurisdiction for at least 10 years and be a member of the Bar of the United States District Court for the District of Columbia or eligible for such admission.

Name: Business address:

Daytime phone number:

Specific areas of legal expertise:

Jurisdictions in which you are admitted to the bar, with dates of admission: Date of admission to bar of the U.S. District Court for the District of Columbia:

Previous mediation experience:

Previous mediation training, including trainers and approximate dates of training:

E. Barrett Prettyman United States Courthouse, 333 Constitution Avenue, N.W., Room 4826, Washington, D.C. 20001 Tel: 202/216-7350 Fax: 202/273-0331

Negotiation experience:

Other relevant experience or skills:

Please indicate why you are interested in becoming a mediator in the U.S. District Court:

I agree, if selected as a United States District Court mediator, to mediate 4-6 cases a year if called upon to do so.

Signature

Note: Please attach a copy of your resume

Submit to:

Jill C. Sayenga, Circuit Executive E. Barrett Prettyman U.S. Courthouse 333 Constitution Avenue, N.W. Room 4826 Washington, D.C. 20001

Revised 1/4/99