MTMA

Montana Mediation Association
Application for Certified Mediator (CM)

Session ID: 83413313229659408048806904

PRIVACY NOTE.  The contents of this application will not be sold or distributed.  Successful applicants will have their name, contact information, and sector of practice published in the MtMA online and print directory.  A résumé may be submitted with this application.

APPLICATION INSTRUCTIONS: Please answer the following questions.  Incomplete applications will be returned for further information.  The Qualifications committee reviews all applications within 7 weeks.  If you have questions, or qualification obstacles, please contact the MtMA Administrator at 406-241-2422 or ..

MEMBERSHIP DESCRIPTION.  A MtMA Certified Mediator (CM) is a mediator, neutral or individual dedicated to processes in which consensual and informed resolutions are made by parties.  CM's must meet MtMA's Certified Mediator Qualifications; subscribe to MtMA's Code of Ethics and Standards of Practice; be interested in furthering the purpose of MtMA; and be current in the payment of annual dues.

MEMBERSHIP DUES and APPLICATION FEES.  If you are not a member, please enclose $95 membership dues plus a $25 application fee with your application.  If membership is denied, your dues, not including the $25 application fee, will be returned.

If you are a current Associate member, please enclose $25 dues, plus a $25 application fee with this application.

Certified Mediator Qualifications

  • 40 hours training or equivalent
  • 8 hours observation
  • 8 hours co-mediation or supervised mediation OR
  • 8 hours solo mediation with 5 hours mentoring and consultation with a CM
  • 15 hours per year continuing education
  • Agree to follow the MtMA Code of Ethics and Standards of Practice

Before filling out this application please read the full list of qualifications on our website at mtmediation.org.
Qualifications Page (PDF): http://bit.ly/1GjpaQy


PART I - Contact Information

Enter your contact information as you wish it to be listed in the membership directory.  All membership materials will be sent to this address.

Title

First Name

MI

Last Name

Address Line 1

Address Line 2

City

State

ZIP Code

Daytime Phone Number

Fax

Email Address

Occupation and employer information will not be printed in the membership directory.

Occupation

Employer

Are you a current Associate member?

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