Membership Form


  1. (Please include all details pertinent to mediation qualifications and experience)

SI.No.MEMBERSHIP CATEGORYENTRANCE FEEANNUAL SUBSCRIPTION FEETICK THE APPROPRIATE MEMBERSHIP CATEGORY
1Individual1000500 
2Individual Life100010,000(one time payment) 
3Institutional1000500 
4Law Firms10,0001000 

8.  Are you attached to a court annexed Mediation Center? If so, please specify which one.

MEMBERSHIP AND FEES:
On being admitted to the society as a member, you will be sent details on how to make payment.

MEMBERSHIP PROPOSED BY:
NAME OF PROPOSER:  
SIGNATURE:

DATE:                                                                                               PLACE:

MEMBERSHIP SECONDED BY:
NAME OF SECONDER:
SIGNATURE:

DATE:                                                                                               PLACE:

I confirm that the information and documents that I have provided/attached to this application form are true and accurate.

SIGNATURE OF APPLICANT:

DATE:                                                                                               PLACE:

PLEASE NOTE:

  1. THOSE APPLYING FOR INDIVIDUAL MEMBERSHIP MUST SUBMIT PROOF OF THE COURSE/S TAKEN CERTIFYING SUCH PERSON TO BE A MEDIATOR.(COPY OF THE CERTIFICATE/S)
  2. GRANTING OR REFUSING MEMBERSHIP SHALL BE AT THE DISCRETION OF THE EXECUTIVE COMMITTEE.
  3. PROPOSER AND SECONDER OF THE MEMBERSHIP APPLICATION SHOULD BE MEMBERS OF MEDIATORS INDIA.
  4. APPLICANTS WISHING TO ADD AN ADDITIONAL SHEET WITH A BIODATA/CV TO ELABORATE ON POINT 7 & 8 OF THE FORM FORM MAY DO SO.