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Application For Registration As Civil Case Mediator - Idaho
| Application For Registration As Civil Case Mediator Form. This is a Idaho form and can be used in Supreme Court Statewide . |
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IDAHO SUPREME COURT APPLICATION FOR REGISTRATION AS A CIVIL CASE MEDIATOR (I.R.C.P. 16(k)) (Other than Child Custody and Visitation Disputes) GENERAL INFORMATION1. Mediator Registration: Qualifications of Court Appointed Mediators To be placed on the Supreme Courts list of civil case mediators, the mediator must be a member of the Idaho State Bar who has been admitted to the practice of law for not less than five (5) ye ars. In addition, the mediator must have attended a minimum of forty (40) contact hours of mediation training that meets the standards set forth in Rule 16(j)(6)(b)(iv), Idaho Rules of Civil Procedure.2. Supporting Documentation An applicant must submit the following to be placed on a list of mediators maintained by the Supreme Court: A. The attached application; B. An affidavit of compliance executed by the applicant attesting that the applicant has fulfilled the requirements for registration; C. A copy of the applicants current Idaho State Bar license; and D. A certificate of completion or other document showing that the applicants mediati on training has been approved by an accredited college or university, the Idaho State Bar, the Idaho Mediation Association, or the Society of Professionals in Dispute Resolution.3. To Remain on the Supreme Court List In order for a mediator to remain on the Supreme Courts list of civil cas e mediators, the mediator must submit proof that the mediator has completed a minimum of twenty (20) contact hours of additional mediation training or education during the preceding two (2) calendar years by completing a program of instruction approved by an accredited college or university or approved by the Idaho State Bar Association, Idaho Mediation Association, or the Society of Professionals in Dispute Resolution. The two calendar year reporting period begins on January 1 of the year the mediator is placed on the lis t unless the mediator is listed after June 30 in which case the two year reporting period begins on January 1 of the foll owing year.4. Applications should be mailed to the Idaho Supreme Court; c/o Administrative Director of the Courts; P.O. Box 83720; Boise, Idaho 83720-0101; telephone # (208) 334-2246.5. I.R.C.P. 16(k), 40(b), and I.R.E. 507 are attached for reference.6. A list of mediators whose applications have been submitted by August 31, 19 96, will be published in September 1996. -97]4-14[ <<<<<<<<<********>>>>>>>>>>>>> 2 IDAHO SUPREME COURT 451 WEST STATE STREET P.O. BOX 83720 BOISE, IDAHO 83720-0101 (208) 334-2246 APPLICATION FOR REGISTRATION AS A CIVIL CASE MEDIATOR (I.R.C.P. 16(k)) (Other than Child Custody and Visitation Disputes) NAME Organization Mailing Address Suite City County State ZIP Telephone ( ) Extension FAX ( ) E-Mail Address The information you furnish above will be used in all correspondence wit h you and in the directory of mediators. I herewith apply for registration on the list of court appointed civil case mediators maintained by the Idaho Supreme Court pursuant to Rule 16(k) I.R.C.P. In support of this application, I state the following: I am a member in good standing of the Idaho State Bar. practice of law for not less than five (5) years. the toed ttmiadI have been <<<<<<<<<********>>>>>>>>>>>>> 3 I have attended a minimum of forty (40) contact hours of mediation training that complies with the standards set forth in Rule 16(j)(6)(B)(iv), Idaho Rules of Civil Procedure. A description of this training is set forth in the attached Addendum Sheet of Mediator Training. I submit the following information for inclusion on the Supreme Courts roster of civil case mediators (other than child custody and visitation disputes). (Please print or type this information in the space provided below using the attached legend of abbreviations where appropriate.) (1) Professional Affiliations: (bar memberships, mediation associations) (2) Education: (3) Legal training and experience: (litigation experience, areas of practice, expertise) (4) Mediation training and experience: (5) Fees and expenses: (6) In addition to the county of my mailing address, I am willing to conduct mediations in the following counties: Signature Date Please return the completed application with supporting documentation to: Idaho Supreme Court Administrative Director of the Courts 451 West State Street P.O. Box 83720 Boise, Idaho 83720-0101<<<<<<<<<********>>>>>>>>>>>>> 4 IDAHO SUPREME COURT 451 WEST STATE STREET P. O. BOX 83720 BOISE, IDAHO 83720-0101 (208) 334-2246 APPLICATION FOR REGISTRATION AS A CIVIL CASE MEDIATOR (Other than Child Custody and Visitation Disputes) ADDENDUM SHEET OF MEDIATOR TRAINING (You must use this sheet to list your mediation training sessions.) NAME ________________________________________________________________ MEDIATOR TRAINING: Name of Entity ListedDescription of Course Contact Below which Sponsored oror Training Hours Dates Approved Training__________________ ___________ _______________ ___________________________________________ ___________ _______________ ___________________________________________ ___________ _______________ ___________________________________________ ___________ _______________ ___________________________________________ ___________ _______________ ___________________________________________ ___________ _______________ _________________________(Attach additional pages if needed.) NOTE: Courses and training sponsored by an accredited college or university do notrequire further approval. Mediation training sessions conducted by other providers must beapproved by the Idaho State Bar, the Idaho Mediation Association, or the Society of Professionals in Dispute Resolution as provided by Rule 16(k) of the Idaho Rules of Civil Procedure. ____________________________________________________________________________ Signature Date<<<<<<<<<********>>>>>>>>>>>>> 5 THE STATE OF IDAHO SUPREME COURT CERTIFICATE OF COMPLETION OF ADDITIONAL CIVIL CASE MEDIATOR EDUCATION Reporting period: _______________ through ________________ To the Supreme Court of the state of Idaho: I, (Print) , hereby certify under penalty of perjury that I have completed a minimum of twenty (20) contact hours of additional mediator education as outlined below, which education has consisted of courses, seminars, or training sessions which have been sponsored or approved by an accredited college or university, the Idaho State Bar, the Idaho Mediation Association, or the Society of Professionals in Dispute Resolution,
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