Application for Civil Mediation Training Application for General Civil Mediation Training Please complete the following application and attach your resume or CV. Our team will contact you to confirm receipt and answer any questions that you may have. Personal InformationName(Required) First Last Address(Required) Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Phone(Required)Email(Required) Confirm Email(Required) The Mediation Center receives funding to provide mediation and conflict resolution training. As part of reporting requirements, please complete the following section.Gender(Required)Please Choose an OptionFemaleMaleTransgenderI do not wish to discloseAge(Required)Please Choose an Option14 or under15 - 19 years20 - 34 years35 - 64 years65 - 84 years85 +Household Income(Required)Please Choose an Option$0 - $9,999$10,000 - $24,999$25,000 - $49,999$50,000 - $74,999$75,000 +Race(Required)Please Choose an OptionAfrican descentAsian/South Pacific descentCaucasian/European descentHispanic/Latino descentIndigenous descentMult-racialRace not identified aboveUnknownTrainingDates of training in which you'd like to enroll(Required)Please Choose an OptionIn Person, August 1st-4th, 2023, 9:00 am - 5:00 pmSign me up for the Newsletter to receive updates on future general civil mediation training opportunities.I will volunteer/privately mediate and agree to pay the following fee to receive the training...(Required) Volunteer Mediator: I wish to take the training and exclusively volunteer as a mediator at the Mediation Center. I understand by choosing this option an interview is required as well as a Volunteer Commitment Form is to be signed before the first day of training. Furthermore, by choosing this option I commit to mediate no less than six (6) cases per year in order to remain on the roster as a volunteer mediator. Private Mediator: I plan to mediate privately and understand there is a $1250 fee to take the training and administration of observations/co-mediations. I understand I am responsible for renewing my registration with GODR annually. The Mediation Center General Civil Mediation Training is approved by the Georgia Office of Dispute Resolution (GODR). All participants receive the same training. Resume of ApplicantMax. file size: 2 GB.A resume is required to process your application. Please upload your resume or email to lrobbins@mediationsavannah.com. Δ