Mediator Application Form

Please fill out the following application. Contact adr@ksd.uscourts.gov with any questions.


Please fill out all information. *=required

Contact Information









 

Bar Admissions






 

ADR Experience



 

ADR Training





 

Legal Experience







 

Fee Structure



 

Compliance



  1. been part of any civil, criminal or administrative proceeding charging you with conduct involving dishonesty, unethical conduct or commission of a crime? or
  2. been disciplined or cited for a breach of ethics or unprofessional conduct by any court, administrative agency, bar association, or other professional group, excluding sanctions in an amount less than $1,000, imposed against you in a civil proceeding?

 










U.S. Federal Court District of Kansas