Volunteer Application
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DISPUTE RESOLUTION CENTER
5407 North IH-35, Suite 410
Austin, TX 78723
Phone #512/371-0033 | Fax #512-371-7411

This application must be filled in, printed out, signed and returned along with two character reference letters to the Dispute Resolution Center (please type in all your information below, then use your browsers "Print" function to print the page). Please read and answer all questions thoroughly. If you need more space, please attach extra sheets to this application.

When did you complete the 40-hours of mediation training (month/year)?

Month: Year:

What organization provided the 40-hours of mediation training you completed and where is it located?*

Organization: Location:

*If your training was provided by an organization other than Corder/Thompson, you must include a copy of your training agenda.

First Name: Last Name:
Mail Address: City, State, Zip:
Work Phone: Home Phone:
Email: Cell Phone:
Birthday: Ethnicity/Gender:
Current Employer: Title/Position:
Education (Schools, Degrees, etc):
Foreign languages in which you are fluent (speak, read, write):

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Do you know American Sign Language (Yes, No)?
Professional Licenses/Certifications (include dates):
Civic, Community & Volunteer Activities:

Why do you want to be a volunteer with the DRC?

What is your understanding of the role of a mediator?

Special training and/or personal experience that would help you as a mediator:


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Have you had any prior experience, directly or indirectly, with mediation or other types of alternative dispute resolution? (Describe)

What types of mediation are you interested in? (circle those that apply)

Civil       Litigation       Family       Juvenile Court       Business

What days and times are you available to mediate?

Would you be interested in volunteering for the DRC in other capacities such as staffing night mediations or other administrative work?

Civil Litigation Mediation Providers are expected to maintain the following standards: Mediate at the DRC at least 4 times per year, attend eight (8) hours of ADR-related continuing education each year, adhere to the DRC Code of Ethics, and have professional liability insurance coverage.

Community Based Mediation Providers are expected to maintain the following standards: Volunteer Mediators are to co-mediate at least six (6) times per year. Eight (8) hours of continuing education are required each year. This commitment helps us to ensure that our clients are having their disputes mediated by qualified mediators. It also ensures that our mediators continue to improve and refine their skills. All mediators should comply with the DRC Code of Ethics when mediating at the Center.

I have read and understand the foregoing. All answers are mine, are true, and are answered to the best of my ability. I understand that inability to meet the standards listed above may render me ineligible to mediate at the DRC.

Signature:____________________________________ Date:__________________________