"Application for Mediation Course Approval" - Arkansas

Application for Mediation Course Approval is a legal document that was released by the Arkansas Judiciary - a government authority operating within Arkansas.

Form Details:

  • The latest edition currently provided by the Arkansas Judiciary;
  • Ready to use and print;
  • Easy to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a fillable version of the form by clicking the link below or browse more documents and templates provided by the Arkansas Judiciary.

ADVERTISEMENT
ADVERTISEMENT

Download "Application for Mediation Course Approval" - Arkansas

300 times
Rate (4.3 / 5) 15 votes
For Office Use Only:
Date Received
Approval Number
Date Approved
Re-Approval Date
A
A
D
R
C
RKANSAS
LTERNATIVE
ISPUTE
ESOLUTION
OMMISSION
Application for Mediation Course Approval
This application will be considered pursuant to approval criteria established by the Arkansas
Alternative Dispute Resolution.
Please read the Commission’s Minimum Standards for
Mediation Training carefully before completing this application. Please type or print all
information.
SECTION I: PROGRAM INFORMATION
1. Name and address of person or organization responsible for the training program:
Phone:
E-mail:
2. Name and affiliation of primary trainer(s):
3. Please attach resumes for each trainer. The resume must contain the following
information:
a. Academic Background/Education
b. Mediation Training
c. Mediation Experience
d. Training Delivery Experience
e. Subject Matter Experience (relevant to the type of training submitted for
approval)
The resume may contain additional information that the trainer would like the
Commission to consider.
4. Name of Course
5. Dates scheduled for the training program:
6. Location at which program will be presented:
1
For Office Use Only:
Date Received
Approval Number
Date Approved
Re-Approval Date
A
A
D
R
C
RKANSAS
LTERNATIVE
ISPUTE
ESOLUTION
OMMISSION
Application for Mediation Course Approval
This application will be considered pursuant to approval criteria established by the Arkansas
Alternative Dispute Resolution.
Please read the Commission’s Minimum Standards for
Mediation Training carefully before completing this application. Please type or print all
information.
SECTION I: PROGRAM INFORMATION
1. Name and address of person or organization responsible for the training program:
Phone:
E-mail:
2. Name and affiliation of primary trainer(s):
3. Please attach resumes for each trainer. The resume must contain the following
information:
a. Academic Background/Education
b. Mediation Training
c. Mediation Experience
d. Training Delivery Experience
e. Subject Matter Experience (relevant to the type of training submitted for
approval)
The resume may contain additional information that the trainer would like the
Commission to consider.
4. Name of Course
5. Dates scheduled for the training program:
6. Location at which program will be presented:
1
7. Cost of training program to participants. Please note that the cost of the program does not
affect course approval. _
8. Has the training program been presented before? Yes
No
If yes:
a. Number of times this training program has been presented:
b. Number of participants in most recent presentation:
c. Attach evaluations of the program by the participants in the most recent
presentation.
9. Minimum number of participants for this course: _
Maximum number of participants for this course:
10. Number of role-plays:
How many times will participant act as mediator?
11. Will you have experienced mediators who will observe and critique the role-plays?
If so, how many experienced mediators will participate in observation?
12. If the trainer does not have the requisite knowledge of Arkansas ADR legislation and
court processes, who will teach those components of the course? A resume must be
attached.
SECTION II: COURSE CONTENT
NOTE: Rather than completing this section, you may provide a detailed agenda that
includes brief descriptions of each topic and the approximate time spent on
lecture, discussion, exercises, and role-plays.
1. Please describe the format of the program and give approximate time spent on the
following: lecture, discussion, exercises, and role-plays. If extra space is needed, please
attach a separate sheet of paper with the number of this question before your response.
2
2. Specific Course Information: Give a brief description of how the course covers each of the
subjects listed below and identify the areas in your attached agenda/ course outline that
correspond to each subject.
1. History of Mediation.
2. An overview of ADR legislation in Arkansas.
3. Conflict Resolution Theory. Please include how the student will develop an
understanding of the differences between mediation and other forms of dispute
resolution.
4. Mediation Theory and Practice. Students should gain a theoretical grounding to
completely understand the processes involved in mediation.
5. Arkansas Legal System and Court Process
6. Mediation Process and Techniques.
3
7. Self-Awareness of Trainee. Student should have a personal awareness of traits or
characteristics that might influence his or her neutrality.
8. Ethics and professionalism.
SECTION III: CHECKLIST FOR TRAINING APPROVAL
Please attach copies of the following, which are required to support the description of the course
content:
1. Outline of course materials;
2. Table of Contents from training textbook;
3. Resumes of trainer(s);
4. Checklist used by observers in evaluating role-plays.
COURSE EVALUATIONS
Trainers must solicit evaluation comments from trainees each time the course is conducted. The
evaluations must be on a form provided by the Commission, and once completed must be
submitted to the Commission.
The trainer must complete a cover sheet for the evaluations
stating the number of attendees in the course and attesting that no evaluations were omitted.
EXAMINATIONS
At the conclusion of the training course, the trainer may be required to administer an exam
provided by the Commission.
COURSE APPROVAL
Once approved by the Commission as satisfying these standards, the course may be offered
repeatedly for a period of three years. Three years from the date of the approval letter, approval
expires and the trainer must re-apply to the Commission to determine if the course meets existing
training standards.
During the three year approval period, the trainer must notify the Commission each time the
course is offered.
This allows the Commission to notify interested parties of training
opportunities and to notify the trainer of any changes to the training requirements.
4
The Commission reserves the right to revoke current approval or deny re-application for
approval of a course based on participant evaluations and other relevant factors.
I,
, certify that the information on this application is correct to the
best of my knowledge and that I will notify the Arkansas Alternative Dispute Resolution
Commission of any changes in primary instructors or course content.
I understand that all
information herein is subject to verification and that the training may be observed at any time by
a representative of the Arkansas Alternative Dispute Resolution Commission as part of the
approval process.
Signature of Person Responsible for Providing Training
Date
Return this application and supporting documents to:
Arkansas Alternative Dispute Resolution Commission
625 Marshall Street Little
Rock, Arkansas 72201 (501)
682-9400
(501) 682-9410 fax
http://courts.arkansas.gov/adr
5
Page of 5