Family Law Mediator Application
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Family Law Mediator Application Form. This is a Washington form and can be use in Skagit Local County.
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Tags: Family Law Mediator Application, Washington Local County, Skagit
SKAGIT COUNTY SUPERIOR COURT
205 W. Kincaid Street, Room 202
Mount Vernon, WA 98273
360-336-9320
FAMILY LAW MEDIATOR APPLICATION
CONTACT INFORMATION
LAST NAME
FIRST NAME
MIDDLE
DATE
BUSINESS NAME OR FIRM
SSN OR TAX ID (CONFIDENTIAL)
STREET AND MAILING ADDRESS
CITY STATE ZIP
BUSINESS PHONE
EDUCATION
LEVEL AND LOCATION OF FORMAL EDUCATION
(ATTACH DETAILED RESUME - MANDATORY)
FAMILY LAW MEDIATOR TRAINING
DATE, SPONSOR AND HOURS ACCOMPLISHED OF BASIC MEDIATION TRAINING (MINIMUM OF 32 HRS REQUIRED)
DATE, SPONSOR AND HOURS COMPLETED OF COURT APPROVED DIVORCE MEDIATION TRAINING
(MINIMUM OF 24 HRS RQUIRED)
PRACTICUM:
Observation of at least six two-hour family law mediation sessions divided among at least three different
mediators. (You must engage in a discussion of the mediations at the conclusion of each session.)
DATES:
MEDIATORS:
Co-mediate three family law cases from beginning to end, each with a different court-approved mediator.
CASE NAMES:
MEDIATORS:
If approved by co-mediators, mediate a family law case solo, with a court-approved mediator observing
throughout the case.
CASE NAME:
MEDIATOR:
CERTIFICATION
I certify under penalty of perjury under the laws of the State of Washington that the foregoing is true and correct.
Signed this ____ day of ________________, at __________________, Washington.
(Signature of Applicant) ________________________________
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