Application For Mediator Recertification {ADR-1003}

FORM ADR-1003 - APPLICATION FOR MEDIATOR RECERTIFICATION. This form is used in Virginia by certified mediators seeking to renew their court-approved certification through the Office of the Executive Secretary of the Supreme Court of Virginia. This form requires updated contact information, certification details, and documentation of continuing mediator education (CME) completed since the last certification period. Applicants must report at least 10 hours of approved CME, including a minimum of 2 hours in mediator ethics, as outlined in Section II (page 2). The form also includes background and disciplinary disclosure questions and requires certification of compliance with Virginia’s mediator ethics standards. Supporting documentation must be attached to verify CME credits. Timely filing is required to maintain eligibility to mediate court-referred cases. www.FormsWorkflow.com