- The Mediation Center of the Coastal Empire

Application for Specialized Domestic Violence Mediation Training

Application to attend the Mediation Center's Specialized Domestic Violence Mediation Training

"*" indicates required fields

Name*

First Last

Are you currently registered with the GODR in the Domestic Relations Mediation category?*

Dates of training in which you'd like to enroll*

Our Center is currently working on a project to increase interest in mediation opportunities among young adults(21-35). To keep track, please tell us your age at the time of training.*

Address*

Street Address Address Line 2 City State ZIP Code

Phone*

Email*

Confirm Email*

Training Fee Scale and Commitment*

I plan to take the Mediation Center training, manage my GODR registration, and do not plan to volunteer at the Mediation Center. I understand there is a $600 fee to take the training. I understand I am responsible for updating my registration with GODR by submitting my training certificate of completion.

Volunteer Option 1: I plan to mediate non-Mediation Center mediation cases. I also wish to volunteer at the Center and commit to mediate 1-2 cases per month for 1 year and understand that the fee is $600. I will be responsible for updating my registration with GODR by submitting my training certificate of completion.

Volunteer Option 2: I plan to mediate non-Mediation Center mediation cases. I also wish to volunteer at the Center and commit to mediate 3-5 cases per month for 1 year and understand that the fee is $300. I will be responsible for updating my registration with GODR by submitting my training certificate of completion.

Volunteer Option 3: I plan to mediate non-Mediation Center mediation cases. I also wish to volunteer at the Center and commit to mediate 6 or more cases per month for 1 year and understand that the fee is waived. I will be responsible for updating my registration with GODR by submitting my training certificate of completion.

Volunteer Option 4: I plan to mediate exclusively through Mediation Center as a volunteer. This volunteer commitment will be ongoing. Therefore, the training fee is waived. To support volunteers, the Center commits to providing free CE opportunities each year. I understand that I have the right to change my mind. If, at any point, I want to mediate non-Mediation Center cases I agree to notify the Center and pay the full training cost.

Resume of Applicant

Max. file size: 200 MB.

A resume is required to process your application. Please upload your resume or email to tmurphy@mediationsavannah.com.

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Application for Specialized Domestic Violence Mediation Training

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