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Online Mediator Certificiation

Online Mediator Certification Application

 Information on the Mediate.com Online Mediator Certification program is here.

Certification Application:

Name
first last
Email
Mediate.com Member #:
Confirm you are already a Mediate.com Certified Mediator:
 yes
 no
  (Required)
Confirm you have provided complete information in your Mediate.com directory record:
 college & graduate degrees
 professional background
 credentials and affiliations
 trainings listed
 mediation practice & approach
 mediation fees
 recent picture
  (R)
Confirm you agree to the stated Online Mediator Standards of Practice:
 yes
 no
  (R)
Confirm you will verify 12 hours of annual online mediation continuing education:
 yes
 no
  (R)
Have you ever been convicted of a felony?
 yes
 no
  (R)
If yes, please describe: (R)
Have you ever been professionally disciplined?
 yes
 no
  (R)
If yes, please describe:
Your additional comments:
I verify the accuracy of all my provided information:
 yes
 no
  (R)
I will update my provided information as reasonably necessary to keep current
yes
no
  (R)
Verification (to make sure you're human)

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Note: Please do not include any URLs in form.

 

We will be in touch with you within no more than 10 days with a decision upon your application or a statement of additional needed information. 

Jim Melamed, 
CEO Mediate.com
admin@mediate.com