ADR Panel Application Form. This is a Rhode Island form and can be use in District Court Federal.
Tags: ADR Panel Application, Rhode Island Federal, District Court
UNITED STATES DISTRICT COURT DISTRICT OF RHODE ISLAND ADR PANEL APPLICATION Please complete the entire application, using additional paper if necessary. You may also attach a resume, however, you must complete and return this application. Name:______________________________________________________________________. Firm or Office Name:__________________________________________________________. Office Address:_______________________________________________________________. Phone:________________________. Fax:___________________________. E-mail______________________________. ADMISSIONS AND AFFILIATIONS Date admitted to the Federal Bar, District of Rhode Island: Date admitted to the Rhode Island Bar: Bar No.: Other courts or jurisdictions to which admitted (with dates of admission and bar nos.): Membership and positions held in bar, ADR and professional associations: Are you a member in good standing in each jurisdiction where admitted to practice law? __No Yes Are you currently the subject of any pending disciplinary proceeding in any jurisdiction? No Yes Have you ever been denied admission to a bar for character or ethical reasons or disciplined for professional misconduct? Yes No EDUCATION: Year law degree received . Law School: . Other professional degrees received (including year and school)_________________________. Other education_________________________________________________________________ American LegalNet, Inc. www.FormsWorkflow.com LEGAL EXPERIENCE(A minimum of 10 years of law practice required): Summarize legal experience since admission to the bar: Percentage of practice in last 5 years representing plaintiff % or defense Percentage of federal or state court practice in last 5 years: Federal Number of years engaged in active litigation: % % State % . EXPERTISE: Indicate all substantive areas in which you have legal or other expertise: ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ PUBLICATIONS: ADR TRAINING & EXPERIENCE Describe your experience and training in ADR. Also, indicate any ADR certifications you hold, when they were awarded and by whom. Page 2 of 3 American LegalNet, Inc. www.FormsWorkflow.com Other courts or organizations for whom you serve as an ADR panel member or neutral mediator: OTHER INFORMATION Please describe any other information, knowledge or skills you wish to be considered as part of this application. CERTIFICATION: I am making application to serve on the ADR Panel for District of Rhode Island and certify that the foregoing is true and correct. Signature Date Return completed application to: Berry B. Mitchell Office of Alternative Dispute Resolution United States District Court 1 Exchange Terrace Providence, RI 02903 Form: ADR Panel Application (April 10, 2008) Page 3 of 3 American LegalNet, Inc. www.FormsWorkflow.com