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ADR Neutral Application - Tennessee
| ADR Neutral Application Form. This is a Tennessee form and can be used in USDC Middle Federal . |
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IN THE UNITED STATES DISTRICT COURT FOR THE MIDDLE DISTRICT OF TENNESSEE QUALIFICATIONS FOR BECOMING A COURT APPOINTED NEUTRAL To become certified as a Mediator, Evaluator, Arbitrator or other type of neutral in this Court,an applicant must have the following qualifications and agree to the following:1. All applicants must be licensed to practice law in the State of Tennessee and must be admitted to practice in any Federal District Court within this State;2. All applicants must have practiced law for at least five years;3. All applicants must have completed at least forty (40) hours of ADR training approved by the Tennessee Supreme Court or the Tennessee Commission on Continuing Education and Specialization; 4. Each applicant must agree to be available to conduct at least one pro bono mediation or early neutral evaluation per year, if requested by the Court;5. Applicants must commit to at least one year of service on this Courts ADR panel;6. Applicants must agree to file any reports required by the Court;7. Applicants must comply with the ethical guidelines set forth in Appendix I to the Local ADR Rules of this Court; 8. All applicants must complete the Application Form approved by this Court, which will be provided to litigants and their attorneys upon request; and9. You will be notified of your acceptance as a panel member by a letter from the Clerk of Court. Please feel free to forward suggestions about improvements to this program at any time to the Clerk of Court.ADRapp.mem <<<<<<<<<********>>>>>>>>>>>>> 2(Rev. 9/00) U.S. District Court For The Middle District Of Tennessee ADR Neutral Application FormName: ______________________________________ BPR #: ___________Office Address: _______________________________ _______________________________ _______________________________ _______________________________ Office Tel. #: ____________________ Office FAX#: ____________________ADR Designation: ___ Mediator ___ Evaluator ___ Arbitrator (You may check more than one) Professional History1. Date admitted to practice in Tennessee: _________________ (Attach copy of law license)2. Date admitted to bar of the U.S. District Court in any district of Tennessee: _____________ (If other than Middle District, attach a copy of a current Certificate of Good Standing)3. Number of years of law practice: ______ (You may count time as law clerk for federal or state judge)4. List areas of the law in which you have significant experience: _____________________________ ______________________________ _____________________________ ______________________________ _____________________________ ______________________________ _____________________________ ______________________________ 2<<<<<<<<<********>>>>>>>>>>>>> 35. Approximately how many jury cases have you tried in the last five (5) years? ______ State Court _______ Federal Court6. Approximately how many cases have you tried non-jury in the last five (5) years? ______ State Court _______ Federal Court7. List any other courts in which you serve or have served in an ADR capacity: (ie; Tennessee Supreme Court, Rule 31 mediator) _____________________________ ______________________________ _____________________________ ______________________________ _____________________________ ______________________________8. Approximately how many times have you served in an ADR neutral capacity? _____9. What is your hourly rate? ____________ Daily minimum charge? _______________10. Attach copies of any certificates of completion or other certifications you have received with regard to ADR training or with regard to being certified as an ADR neutral.11. Attach any resume of training or experience which you feel might be helpful to any litigant or attorney who may be considering using your services as an ADR neutral.12. Have you ever been disciplined as a lawyer by any court, bar association, or regulatory body? ______ (If so, please attach a full explanation of the complaint, regulatory body, date of disposition and any discipline received.) 13. Have you ever been convicted of a felony? ______ (If so, please attach a full explanation of the charges, including jurisdiction, case number, date of disposition and any penalty imposed.) I hereby agree to abide by any and all requirements of service as an ADR neutral listed in theQualifications, attached hereto, and the Local Rules of Court promulgated by the United States DistrictCourt for the Middle District of Tennessee. _____________________________Date: ________________ Signature 3
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