FORM 12 (FC) (rev. 3/16) NORTH CAROLINA 28th JUDICIAL DISTRICT BUNCOMBE COUNTY IN THE GENERAL COURT OF JUSTICE DISTRICT COURT DIVISION _____-CVD- ______ Judge: _____________________________ ____________________________________, Plaintiff ORDER TO ATTEND PARENT EDUCATION/ MEDIATION ORIENTATION & MEDIATION A copy of this signed order must be sent by the Moving Party to the Responding Party and it shall operate as both Parties' Order to Attend vs. _________________________________, Defendant. PLEASE TAKE NOTICE that Pursuant to N.C.G.S. 50-13.1 (b), this case is hereby scheduled for mandatory mediation of all custody and visitation issues. This includes a mandatory 2-1/2 hour Parent Education/ Mediation Orientation class (scheduled below) that educates parents on the impact of parental conflict on children and introduces parents to the mediation process as well as one mandatory mediation session (to be scheduled at the Parent Education/Orientation session). YOU ARE ORDERED TO APPEAR for a 2-1/2 hour Parent Education/Mediation Orientation class in the Buncombe County Judicial Complex, Jury Assembly Suite, Room 272, 2nd Floor, 60 Court Plaza, Asheville NC, as follows: For Plaintiff: ____________________________________________________________at 10:00AM For Defendant: ____________________________________________________________at 10:00AM ALL PARTIES ARE REQUIRED TO ATTEND ON THE DATES AS SET FORTH ABOVE, unless: The parties herein have previously participated in the custody mediation program and completed the Parent Education/Orientation class within the past 12 months. Both parties shall, within 10 days from the date of this Order to Attend, contact the Custody Mediator at: (828) 259-6505 to schedule a mediation appointment to address the new custody issues. PLEASE NOTE: 1. 2. 3. 4. FAILURE TO ATTEND THESE EVENTS MAY RESULT IN CONTEMPT AND MANDATORY FINES. Please allow two and one-half hours for the Parent Education/Mediation Orientation Class. CHILDREN ARE NOT PERMITTED TO ATTEND. If you have any concerns about your physical safety, please contact the Custody Mediator at 259-6505. I HEREBY CERTIFY that a copy of this Order to Attend Parent Education/Mediation Orientation & Mediation has been served in the following manner: by certified U. S. mail, return receipt requested, in a properly addressed, postpaid envelope to: Name________________________ Address ___________________________City____________State____Zip __________ OR by Sheriff's service AND, a copy of this document has been provided to the Family Court Case Coordinator, Family Court Office, 28 th Judicial District, 60 Court Plaza, 3rd Floor, Asheville, North Carolina 28801. This is the _______day of, 20________ . _______________________________________________ Signature (Moving Party or Counsel for Moving Party) American LegalNet, Inc. www.FormsWorkFlow.com FORM 12 (FC) (rev. 3/16) STATE OF NORTH CAROLINA 28TH JUDICIAL DISTRICT BUNCOMBE COUNTY File No. CVD __. IN THE GENERAL COURT OF JUSTICE DISTRICT COURT DIVISION REFERRAL FOR CUSTODY MEDIATION INSTRUCTIONS: Please fill in the following information: Name of Plaintiff: Day ph #: Email: Address: Date of birth: Night ph #: Name and address of Attorney: Ph #: Fax #: Name of Defendant: Day ph #: Email: Night ph #: Address: Date of birth: Name and address of Attorney: Ph #: Fax #: Marriage date: Parties never married: Separation date: ______________________ **The parties are the parents of the child(ren) named below: Name Age DOB Name of person w/ whom child resides Relationship Has this court case been in mediation before? If yes, give the name of the mediator Signature: Yes No If yes, approximate date_____________ Date: American LegalNet, Inc. www.FormsWorkFlow.com