Mediator Application

IN THE UNITED STATES DISTRICT COURT FOR THE DISTRICT OF NEBRASKA MEDIATOR APPLICATION Name: Address: Phone: Fax: E-Mail: I have completed mediation tra ining pursuant 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 was admitted to the practice of law in the following state(s) in the months and years indicated below: 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 1 <<<<<<<<<********>>>>>>>>>>>>> 2I am currently in good standing as an attorney before the United States District Court for the District of Nebraska: yes no I have completed at least twenty-four (24) hours of sp ecialized training in mediating cases in federal district court. I completed the federal mediation training held on (date). Other training in the practice of mediation which I have received is detailed below. (State the date, place, sponsor, trainers, subj ects c overed, and number of hours involved for each training session you have completed; you need not repeat training which has been described in previous applications): 2 <<<<<<<<<********>>>>>>>>>>>>> 3 Ihave completed at least three supervised mediations. List each case, the type of dispute, the date, a nd the name of the supervisor: 1. 2. 3. I have mediated the following disputes which were not then in liti gation : (State the date, place, parties, nature of dispute, number of mediation sessions involved, and whet her the mediation was successful in resolving the dispute. You need not repeat mediations reported in an earlier application to this court). 1. 2. 3. 3 <<<<<<<<<********>>>>>>>>>>>>> 44. 5. I have mediated the following disputes which were in litigation atthe time of the mediation. (State the date, place, parties, attorneys, nature of dispute, court, number of mediation sessions required, and whether the di spute was successfully resolved as aresult of the mediation. You need not repeat information supplied in an earlier application to this court): 1. 2. 4 <<<<<<<<<********>>>>>>>>>>>>> 53. 4. 5. 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, as 5 <<<<<<<<<********>>>>>>>>>>>>> 6follows: 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. If 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 persona l level of knowledge and experi ence in the subjec t areas lis ted below. I have suf fic ient k nowledge an d experience litigating and/or me diati ng cases in the follow ing areas o flaw that I am competent t o handle fed eral case m ediations i nvolving th ese subject are as: 6 <<<<<<<<<********>>>>>>>>>>>>> 7 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 RIGHTS Personal 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 Product Liability ___ 470 Racketeer Influenced & Corrupt Org. ___ 810 Selective Service CIVIL RIGHTS ___ 850 Securities/Commodities/Exchange ___ 441 Voting ___ 875 Customer Challenge 12 USC 3410 ___ 442 Employment ___ 891 Agricultural Acts ___ 443 Housing/Accommodations ___ 892 Economic Stabilization Act ___ 444 Welfare ___ 893 Environmental Matters ___ 440 O