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Agreement To Serve As Voluntary Mediator - Oregon
| Agreement To Serve As Voluntary Mediator Form. This is a Oregon form and can be used in District Court Federal . |
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United States District Court District of Oregon Agreement to Serve as a Voluntary Mediator G This is a new application G I am presently on the courts list of Volunteer Mediators 1. Personal Information: Name: Last First Middle Initial Mailing Address: Oregon State Bar ID Number: Phone Number: Fax Number: Business e-mail address: 2. Law Firm and Practice Information: Law firm name: Principal area of practice (please identify if predominantly plaintiff or defense): Other fields of training and/or experience: Legal or Non-legal organizations with whom you are affiliated: Mediation Training Experience: Court Divisions you would be willing to serve in (check as many as apply): G Portland G Pendleton G Eugene G Medford I certify that I have read Local Rule 16.4, that I am a member in good standing with the Oregon State Bar, and that I have been admitted to practice in the United States District Court for the District of Oregon for at least five years, and/or I am a retired or senior judge. _____________________________________ __________________ Signature Date <<<<<<<<<********>>>>>>>>>>>>> 2 CASE PREFERENCE AND SELF-EVALUATION Please mark each case category in the appropriate place to indicate your expertise in the area and/or yourinterest in arbitrating that type of case. Major Experience means that this is or has been a major emphasisof your practice. Some Experience means that you are familiar with the basic principles of law and have hadsome experience in that area. Little or No Experience means that you have little or no experience in the area,but that you are still interested in hearing such case. Dont Want means that you would prefer not to be appointed to this type of case for any reason. Case Type Major Some Little or No Dont Experience Experience Experience Want Contracts -- General Business Government.................... Insurance...................... Real Property -- General Condemnation.................. Personal Injury -- General Airplane....................... Defamation.................... FELA ......................... Maritime ...................... Product Liability................ Medical Malpractice............ Asbestos ...................... Civil Rights -- General Labor & Employment -- General Traditional Labor Law........... Wrongful Discharge............. ERISA Pension............... Wage Claims Intellectual Property -- General Patent......................... Trademark..................... Copyright...................... Other: Admiralty...................... Environmental.................. Antitrust....................... Banking....................... RICO ......................... Securities ..................... Other (Specify) ____________________________________________________________________________________ Return to: Danny W. Armstrong (503-326-8091) Portland Division Manager ADR Administration Section 740 U.S. Courthouse, 1000 SW Third Ave. Portland, OR 97204
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