Application for Admission to Roster of Mediators for Civil General Equity and Probate Cases

APPLICATION FOR ADMISSION TO ROSTER OF MEDIATORS
FOR CIVIL, GENERAL EQUITY AND PROBATE CASES

Please complete all applicable sections of this application. Fields below correspond to the form on page 1.

The following information will be used to determine eligibility: (See criteria on back.)

Have you ever been disciplined in your profession? Yes No

Court/state/local government employee or law enforcement officer? Yes No

The following information will be included on the roster if you are accepted:

Areas of expertise for mediation (check all that apply):

Descriptive paragraph (maximum of 50 words about your mediation and other relevant professional experience):

I certify that the foregoing statements made by me are true and that I am in good standing in my profession.

Return this form to:

Michelle V. Perone, Esq., Chief, Civil Court Programs, Administrative Office of the Courts

PO Box 981 Trenton, NJ 08625

Or Fax to (609) 777-0844. Rev. 9/1/06

Must provide documentation that you have handled, as a practitioner, at least 15 lemon law cases in the past 5 years in order to list this case type.

ROSTER OF MEDIATORS FOR CIVIL, GENERAL EQUITY AND PROBATE CASES

Criteria for Admission

Eligibility will be determined by a Subcommittee of the Supreme Court Committee on Complementary Dispute Resolution.

Mediation Training

Successful completion of a minimum of 18 hours in an approved mediation course meeting the standards of Rule 1:40-12(b)(4) and at least 5 hours being mentored in at least two cases in the Superior Court by an experienced mediator listed on the approved roster of mentors.

List of mentors and guidelines for mentoring program are available on the Judiciary Website www.njcourtsonline.com or will be provided by Administrative Office of the Courts subsequent to submission of application.

Education / Mediation Experience

One of the following two combinations of Education and Mediation Experience:

1) Juris Doctor (or equivalent law degree) or advanced degree in Business, Finance, or Accounting, or advanced degree in a field of expertise in which the individual will practice mediation, or State Licensure in the professional field and evidence of successful mediation of at least two cases within the last year.

2) Undergraduate degree and evidence of successful mediation of at least ten cases involving subject matter cognizable in the Superior Court within the last five years.

Professional Experience

At least five years of professional experience in the field of expertise as set forth under Rule 1:40-12(a)(3).

Annual Continuing Education

Attendance at a minimum of four hours of annual continuing education as set forth under Rule 1:40-12(b)(3).

Counties in Which You Will Accept Cases

Please note that you are expected to provide facilities to the parties at no cost in each county you list and that you cannot charge for travel time or expenses during the first two hours.