Mediator Renewal Application

IN THE UNITED STATES DISTRICT COURT FOR THE DISTRICT OF NEBRASKA MEDIATOR RENEWAL APPLICATION Name: Address: Phone: Fax: E-Mail: I have completed mediation training pur suan t to the Nebraska Dispute Resolution Act, and I am associated with the following state mediation center(s): Center Name Center Name Center Address Center Address I h ave been admitted to the practice of law in the following state(s) since my last approval: state month, year state month, year state month, year I am currently in good standing as an attorney before the courts of Nebraska: yes no I am currently in good standing as an attorney before the Unite dStates District Court for the District of Nebraska: 1 <<<<<<<<<********>>>>>>>>>>>>> 2 yes no Other training in the practice of mediation which I have received since my last approval is detailed below. (State the date, place, sponsor, trainers, subjects covered, and number of hours involved for each training session you have completed; you need not repeat training which has been described in previous applications): Since my last approval, I have mediated the following disputes 2 <<<<<<<<<********>>>>>>>>>>>>> 3which were not then in litigation: (State the date, place, parties, nature of dispute, number of mediation sessions involved,and whether the mediation was successful in resolving the dispute. You need not repeat mediations reported in an earlier application to this court). 1. 2. 3. 4. 5. 3 <<<<<<<<<********>>>>>>>>>>>>> 4 Since my last approval, I have mediated the following disputeswhich were in litigation at the time of the mediation. (State thedate, place, parties, attorneys, nature of dispute, court, numberof mediation sessions required, and whether the dispute wassuccessfully resolved as a result of the mediation. You need notrepeat information supplied in an earlier application to thiscourt. Include mediations referred from federal court, as well asothers. Attach additional pages if necessary.): 1. 2. 3. 4. 4<<<<<<<<<********>>>>>>>>>>>>> 5 5. Since my last approval, I have participated in the following: Annual Mediation Workshop in July, 1996. Annual Mediation Skills Workshop in May, 1997. Annual Mediation Skills Workshop in April, 1998. Annual Mediation Skills Workshop in July, 1999. Annual Mediation Skills Workshop in September, 2000._____ Annual Mediation Skills Workshop in November, 2002. Continuing Education Courses Completed in Mediation (listtitle and sponsor of the workshop, date, location, subjectscovered, and number of hours): 5<<<<<<<<<********>>>>>>>>>>>>> 6 INSTRUCTIONS FOR DECLARATION OF COMPETENCE Lawyers representing clients in federal litigation want to know your knowledge and experience level in the substantive law of their cases. Sometimes a background of specialized study, or representing a client in only one major cases is enough to sufficiently learn the law for mediation purposes; other times, significant trial and pretrial litigation experience is necessary to be adequately conversant in the subject matter to handle a mediation. While law review expertise is not necessary, you should be knowledgeable enough about the substantive law that you can converse with the lawyers about the elements of the claim and the various defenses that might apply, as well as the practical aspects of settling cases in that subject area. Please think carefully about your personal level of competence in these subjectareas, and declare only those areas in which you feel confident representing yourself to fellow lawyers as competent to mediate, asfollows: Designate with a 1" only those areas in which you feel comfortable as your primary subject areas of competence. You will be contacted to mediate cases in those subject areas. 6 <<<<<<<<<********>>>>>>>>>>>>> 7If there are other areas of law in which you have some competence, but do not feel comfortable mediating alone, you may designate those with a 2. You may be asked to co-mediate cases in those subject areas with another mediator who has designated that area as one of primary competence. DECLARATION OF COMPETENCE I have care fully revie wed my personal l evel of kno wledge and experience in the subjec t areas lis ted below. I have sufficient knowledge a nd experience litigating and/or med iating case s in the follo wing areas oflaw that I am competent to handle federal cas e mediation s involving these subject are as: 7 <<<<<<<<<********>>>>>>>>>>>>> 8 CONTRACT PRISONER PETITIONS - CONTINUED___ 110 Insurance ___ 540 Mandamus & Other ___ 120 Marine ___ 550 Civil Rights ___ 130 Miller Act ___ 555 Prison Condition ___ 140 Negotiable Instrument FORFEITURE/PENALTY___ 150 Recovery of Overpayment & ___ 610 Agriculture Enforcement of Judgment ___ 620 Other Food & Drug ___ 151 Medicare Act ___ 625 Drug Related Seizure of Property___ 152 Recovery of Defaulted Student Loans 21 USC 881 (Excl. Veterans) ___ 630 Liquor Laws ___ 153 Recovery of Overpayment of ___ 640 R.R. & Truck Veterans Benefits ___ 650 Airline Regs. ___ 160 Stockholders Suits ___ 660 Occupational Safety/Health___ 190 Other Contract ___ 690 Other ___ 195 Contract Product Liability LABOR REAL PROPERTY ___ 710 Fair Labor Standards Act___ 210 Land Condemnation ___ 720 Labor/Mgmt. Relations ___ 220 Foreclosure ___ 730 Labor/Mgmt. Reporting & Disclosure___ 230 Rent Lease & Ejectment Act ___ 240 Torts to Land ___ 740 Railway Labor Act ___ 245 Tort Product Liability ___ 790 Other Labor Litigation___ 290 All Other Real Property ___ 791 Empl. Ret. Inc. Security Act TORTS PROPERTY RIGHTSPersonal Injury ___ 820 Copyrights ___ 310 Airplane ___ 830 Patent ___ 315 Airplane Product Liability ___ 840 Trademark ___ 320 Assault, Libel & Slander SOCIAL SECURITY___ 330 Federal Employers Liability ___ 861 HIA (1395ff) ___ 340 Marine ___ 862 Black Lung (923) ___ 345 Marine Product Liability ___ 863 DIWC/DIWW (405(g)) ___ 350 Motor Vehicle ___ 864 SSID Title XVI ___ 355 Motor Vehicle Product Liability ___ 865 RSI (405(g)) ___ 360 Other Personal Injury FEDERAL TAX SUITS___ 362 Personal Injury - Medical ___ 870 Taxes (U.S. Plaintiff or Defendant) Malpractice ___ 871 IRS - Third Party 26 USC 7609___ 365 Personal Injury - Product Liability OTHER STATUTES___ 368 Asbestos Personal Injury Product ___ 400 State Reapportionment Liability ___ 410 Antitrust Personal Property ___ 430 Banks and Banking ___ 370 Other Fraud ___ 450 Commerce/ICC Rates/etc.___ 371 Truth in Lending ___ 460 Deportation ___ 380 Other Personal Property Damage ___ 385 Property Damage Pr