450 Bryant St., Palo Alto, CA 94301
Tel: (650) 856-4062, Fax: (408) 720-0810
The Palo Alto Mediation Program is administered by Project Sentinel in partnership with
the City of Palo Alto’s Human Relations Commission and Human Services Department
2011 APPLICATION FOR PALO ALTO MEDIATION PROGRAM
Thank you for your interest in the Palo Alto Mediation Program (PAMP). Please email your completed application to by Friday, March 25, 2011. Use as much space as you need to answer questions fully. Initial candidate screening will be based on this application only.
Name: ______
Home Address: ______
Employer Name and Address: ______
(Note: It is a requirement that you work, or live, or own property in Palo Alto or Stanford.)
E-mail Address (required): ______
Home Telephone: ( ) ______
Work Telephone: ( ) ______Primary Work Hours: ______
1. How did you hear about the Palo Alto Mediation Program (PAMP)? Please check all that apply.
Newspaper ad (which paper?): ______
Referral: name of person: ______
Online: if so, where? ______
Flyer: if so, where? ______
Other: ______
2. a. What interests you about becoming a mediator for the city of Palo Alto?
- How would being a mediator fit into your personal or career goals?
3. a. What skill or life experience do you think you would bring to the Palo Alto Mediation Program? Please elaborate on one.
b. What training or experience have you had that might be relevant (such as facilitation, mediation, communication, diversity)?
4. Have you ever been involved in a mediation? Yes _____ No _____
If yes, were you:
Mediator _____Party _____ Observer _____
Optional:Please tell us a bit about it (what kind of case was it,and what did you think of the process, or how it might have been better?)
5. What previous experience do you have as avolunteer in community service or other activity? If you have not done community service work recently, please explain why you are interested in volunteering now.
6. Do you speak/have knowledge of languages other than English? Yes _____ No _____
In which languages other than English are you fluent? (That is, you would feel comfortable using the language during a mediation) ______
In which languages do you have a working knowledge, but are not fluent?
______
What is your first language? ______
7. a. How would you describe your current work situation?
Working full time
Working part time
In school: If so, where? ______
Retired
Raising children, care taking
In between jobs
Other
b. The PAMP is composed of members who come from a variety of backgrounds. What kind of work do you currently do or have you recently done?
c. Do you anticipate your work situation changing in the next year or so? For instance, are you considering retirement, returning to school, a job or career change?
d. Mediations are scheduled at the convenience of the parties, rather than the mediators. Therefore, if your schedule has limited flexibility, especially during weekdays, this may impact your ability to volunteer for mediations. However, it would not limit your ability to do case development with parties on the telephone.
Understanding that everyone’s schedule may vary from week to week, when would you be most likely to be available to participate in mediations? Please put a “yes” next to times that are generally convenient for you, and a “no” next to times that are typically difficult or impossible.
Please fill out each of the time periods with a “yes” or a “no.”
- Weekday mornings_____
- Weekday afternoons_____
- Weekday evenings_____
- Weekend days _____
e. Please comment on anything you would like the Selection Committee to know about concerning your constraints in general, and/or how you anticipate your availability might change in the next year or so:
8.Which of the following additional PAMP activities (besides mediating) might be of interest to you? Check all that apply:
Speaking to Palo Alto community groups about the PAMP and mediation
Helping with promotion, outreach in general (to city referrers, the public, etc.)
Graphic design, copywriting, website development (be specific):______
Facilitating at community events (if you have facilitation training or experience)
Other: ______
The following questions will enable you to plan ahead as you consider becoming a PAMP mediator:
9.If you are selected as a finalist, will you be available to meet with the Selection Committee on April 26, 27or 28 for a short (20 minute) panel interview? (We will try to accommodate your schedule on one of these days to the best of our ability.)
Yes ___ No ___
10. The PAMP uses e-mail to assign cases, to schedule meetings, and for general communications. Do you have access to e-mail (especially during the day), and check it with some frequency?
Yes___ No ___
11. If you’re not already a qualified mediator who has completed a 40-hour basic community mediation training, the City of Palo Alto requires you to take a mediation course. The primary training course used by PAMP consists of five full days of training, from 9 a.m. to 5:30 p.m., on three weekends (TBD) during June. The fee for this course is approximately $450 and is paid by the participants. The schedule for this training will be posted on our website ( and emailed to applicants as soon as it is established. If this class schedule presents a problem for you there are other courses that can fulfill this requirement. However, an equivalent course must be completed before June 30, 2011 for you to be considered for an interview.
Are you able to attend this required training, subject to your availability on the dates that are selected? (More details about the training may be found in the Q&A document that accompanied this application.)
Yes___ No ___
12. If you believe you are already a trained community mediator and would like to be considered as fully trained, please indicate where your training took place, the approximate date, the instructor, and any other information about the nature of the training:
13. Are you available to attend monthly PAMP meetingsusually held on the third Thursday of the month from 7:15 to 8:45 p.m.?
Yes___ No ___
(Note: Attendance at meetings is required by the PAMP by-laws. No meetings are held in July, August, and December; however, new mediator orientation meetings are held in July and December, at dates TBD. Meetings include opportunities to talk about cases with other mediators and skill development.)
14. Are you willing to devote an average of six to ten hours a month on mediation activities, including mediations, case development, outreach, and monthly PAMP meetings?
Yes___ No ___
15. What questions or concerns, if any, do you have about becoming a PAMP mediator? We will try to address these during the application process.
Name of ApplicantDate
The deadline for receiving your application is Friday, March 25, 2011by close of business. Please submit your application via e-mail to our Case Manager, Ric Rudman, at .
Thank you for taking the time to apply to the PAMP! We appreciate your interest in the program.
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