ADR Resolution Corps Application

Name:
Company:
Address:
Phone:
Email:
Practice Areas:

Business
Family/Divorce
Civil
Landlord/Tenant
Employment
Probate
Elder
Other:
Question 1:

Do you or does your firm currently carry liability insurance in an amount that covers the activities of the individual applicant? Yes or No?
Question 2 :

Please provide a brief summary of no more than 250 words of your virtual dispute resolution experience:
CERTIFICATION
.:

I,________(name), by my signature below, hereby certify that I meet the following requirements for inclusion on ADR Section Resolution Corps Panel as follows (please check all that apply):
Check all that apply:

I am a CBA-ADR Section Member in good standing.
I have and will participate in at least one virtual dispute resolution training or practicum each year.
I have conducted at least five (5) virtual dispute resolution processes as solo or as lead, including but not limited to mediation, negotiation, arbitration and other hybrid processes.
I have and will continue to obtain supplemental education and experience in the areas in which I practice of at least 10 hours per year.
In my mediation practice, I agree to abide by the Colorado Model Standards of Conduct for Mediators.
I agree to provide pro bono mediation services to at least one case per year as needed, referred to me as a Resolution Corps panelist.
I do not have any pending or prior (within the last five years) formal reprimands, disciplinary actions, complaints with a grievance committee of any bar or professional association or with the designated disciplinary entity of any state, any pending or prior felony criminal charges or convictions, or judgments, settlements, or admissions of malpractice.
If added to the Resolution Corps panel, you agree to defend, indemnify and hold harmless CBA, its employees, directors, officers, shareholders, affiliated companies, agents, vendors, and suppliers from and against any and all claims, damages, costs and expenses, including reasonable attorneys’ fees, arising from or related to your inclusion on the Resolution Corps mediation panel.
If you are unable to affirmatively assert any of the above, please provide a detailed explanation in writing and attach it to this application. Information and documentation received shall be reviewed only by the Advisory Group Application Review Subcommittee and/or the ADR Executive Council solely for the purpose of approving or denying the application. Information and documentation shall not be used or distributed for any other purpose and shall be kept secure.

Your application and supporting documents will be kept for the period necessary to fulfill the purposes outlined herein, unless a longer retention period is required or permitted by law. This may include retaining your application and supporting documents to comply with our legal obligations, resolve disputes, or enforce any of our agreements. Please note that you can request, at any time, that we delete your application and supporting documents.
Resume :
By my signature below, I certify that the above statements are true and correct to the best of my knowledge.
Date: *
Name (signature) : *
Please verify you are not a robot!

CBA-ADR Section Resolution Corps Virtual Dispute Resolution Panel

CBA-ADR Section Resolution Corps

Virtual Dispute Resolution Panel