Coordinated by the Ind. Comm. for Continuing Legal Education

DISTRICT 10 Mortgage Foreclosure Mediation Program

Questions marked with a * are required.

 
*1. First Name:
 
2. Middle Initial:
 
*3. Last Name:
 
*4. Attorney/Mediator Number:
 
5. Firm/Organization:
 
6. Street Address:
 
7. City:
 
8. State:
 
9. ZIP Code:
 
*10. Telephone Number:
 
11. E-mail:
 
*12. I am currently registered as a Civil Mediator in the State of Indiana, or will be registered as such by the applicable training date.
Yes
No
 
13. If Yes, What is the estimated number of cases for which you have served as a mediator:
 
14. If No, please explain your interest in these trainings (e.g. Indiana Judicial officer, Indiana certified foreclosure counselor, etc.). Your placement will be confirmed prior to final registration.
 
15. I would rate my professional experience with foreclosures as:
Very Experienced
Somewhat Experienced
No Previous Experience
 
16. Equipment:
I will bring a laptop or portable computing device to access and review files electronically.
I will not bring a laptop or portable computing device to access and review files electronically.
 
17. Mediators: I understand that in exchange for attending this training at no cost, a reasonable pledge of pro bono mediation services will be required. Specifics of this pledge will be tailored to maximize local impact. Details of this agreement will be provided at the training.
Yes
No
 

If you experience any difficulties submitting the registration, please contact Justin R. Corbett, Executive Director & Mediator, at INDYSPUTE Resolution & Dialogue Center, (317) 633-4283, corbett@indyspute.org.

NOTE: Please click the "submit survey" button ONLY ONCE. It may take a few minutes for the page to refresh showing that your registration has been successfully submitted. Please be patient. If you click the button more than once, your registration will be duplicated.