SUPERIOR COURT OF CALIFORNIA, COUNTY OF SANTA CLARA ADR ATTENDANCE FORM/CIVIL DIVISION PLEASE MAIL WITHIN 10 DAYS OF THE COMPLETION OF THE ADR PROCESS TO: ELIZABETH STRICKLAND, ADR ADMINISTRATOR SANTA CLARA COUNTY SUPERIOR COURT 191 N. FIRST STREET, SAN JOSE, CA, 95113 OR FAX TO 408-882-2595 Case Name: ___________________________________Case No: ______________________ Your Name: ______________________________Your Phone Number:__________________ ADR Process: Mediation Neutral Evaluation Other (specify):__________________ Instructions: This form will be used for evaluation of the ADR program. List the names, addresses, phone numbers, and fax numbers, as available, for all parties, attorneys and other party representatives who participate in any ADR session in this case, either in person or by phone. Attach additional pages, if necessary. Dates of ADR Sessions: PARTIES (Counsel should place an X by the names of parties who may not be contacted for an evaluation of the ADR program without counsel permission.) Name:_______________________________ Address: ____________________________ _____________________________________ _____________________________________ Phone: ______________________________ FAX: _______________________________ Name:_______________________________ Address: ____________________________ _____________________________________ _____________________________________ Phone: ______________________________ FAX: _______________________________ Name:_______________________________ Address: ____________________________ _____________________________________ _____________________________________ Phone: ______________________________ FAX: _______________________________ Name:_______________________________ Address: ____________________________ _____________________________________ _____________________________________ Phone: ______________________________ FAX: _______________________________ Name:_______________________________ Address: ____________________________ _____________________________________ _____________________________________ Phone: ______________________________ FAX: _______________________________ Name:_______________________________ Address: ____________________________ _____________________________________ _____________________________________ Phone: ______________________________ FAX: _______________________________ ADR ATTENDANCE FORM/CIVIL DIVISION CV-5001 REV 5/06 American LegalNet, Inc. www.FormsWorkflow.com ATTORNEYS Name:_______________________________ Address: ____________________________ _____________________________________ _____________________________________ Phone: ______________________________ FAX: _______________________________ Representing ________________________ Name:_______________________________ Address: ____________________________ _____________________________________ _____________________________________ Phone: ______________________________ FAX: _______________________________ Representing ________________________ Name:_______________________________ Address: ____________________________ _____________________________________ _____________________________________ Phone: ______________________________ FAX: _______________________________ Representing ________________________ Name:_______________________________ Address: ____________________________ _____________________________________ _____________________________________ Phone: ______________________________ FAX: _______________________________ Representing ________________________ Name:_______________________________ Address: ____________________________ _____________________________________ _____________________________________ Phone: ______________________________ FAX: _______________________________ Representing ________________________ Name:_______________________________ Address: ____________________________ _____________________________________ _____________________________________ Phone: ______________________________ FAX: _______________________________ Representing ________________________ OTHER PARTY REPRESENTATIVES Name:_______________________________ Address: ____________________________ _____________________________________ _____________________________________ Phone: ______________________________ FAX: _______________________________ Representing ________________________ Name:_______________________________ Address: ____________________________ _____________________________________ _____________________________________ Phone: ______________________________ FAX: _______________________________ Representing ________________________ Name:_______________________________ Address: ____________________________ _____________________________________ _____________________________________ Phone: ______________________________ FAX: _______________________________ Representing ________________________ Name:_______________________________ Address: ____________________________ _____________________________________ _____________________________________ Phone: ______________________________ FAX: _______________________________ Representing ________________________ ADR ATTENDANCE FORM/CIVIL DIVISION CV-5001 REV 5/06 American LegalNet, Inc. www.FormsWorkflow.com