FORM 27. Confidential Joint Request to Enter Appellate Mediation Program Form27 Rev. 03/16 UNITED STATES COURT OF APPEALS FOR THE FEDERAL CIRCUIT CONFIDENTIAL JOINT REQUEST TO ENTER APPELLATE MEDIATION PROGRAM v. No. We would like the above case considered for entry into the Appellate Mediation Program (counsel for all parties must sign). Signature of Counsel for: Appellant/Petitioner Appellee/Respondent Cross-Appellant Intervenor Signature of Counsel for: Appellant/Petitioner Appellee/Respondent Cross-Appellant Intervenor Name of Party represented: Name of Party represented: Law Firm Law Firm Address City/State/Zip Telephone Fax Number E-Mail This Joint Mediation Request must be submitted to the Circuit Mediation Administrator. Please send completed form to: Address City/State/Zip Telephone Fax Number E-Mail Circuit Mediation Administrator Office of General Counsel, Mediation 717 Madison Place, NW Washington, DC 20439 American LegalNet, Inc. www.FormsWorkFlow.com