Membership Form
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(Please include all details pertinent to mediation qualifications and experience)
| SI.No. | MEMBERSHIP CATEGORY | ENTRANCE FEE | ANNUAL SUBSCRIPTION FEE | TICK THE APPROPRIATE MEMBERSHIP CATEGORY |
|---|---|---|---|---|
| 1 | Individual | 1000 | 500 | |
| 2 | Individual Life | 1000 | 10,000(one time payment) | |
| 3 | Institutional | 1000 | 500 | |
| 4 | Law Firms | 10,000 | 1000 |
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:
- 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)
- GRANTING OR REFUSING MEMBERSHIP SHALL BE AT THE DISCRETION OF THE EXECUTIVE COMMITTEE.
- PROPOSER AND SECONDER OF THE MEMBERSHIP APPLICATION SHOULD BE MEMBERS OF MEDIATORS INDIA.
- APPLICANTS WISHING TO ADD AN ADDITIONAL SHEET WITH A BIODATA/CV TO ELABORATE ON POINT 7 & 8 OF THE FORM FORM MAY DO SO.