Application forCommunity Mediation Training
A 30-40 hr training that has been approved by the TN Supreme Court Rule 31
Contact Information:
Name: ______Date: ______
Address: ______Eve Phone: ______
City: ______Zip: ______Cell Phone: ______
I prefer to be contacted at: ______Day Phone: ______
E-Mail:______Do you check regularly? ______
How did you hear about NCRC? ______
______
NCRC is committed to ensuring diversity in its trainings. Please tell us about your background:
Race/ethnicity: ______Country of birth: ______
Gender (check one): Female Male Age: ______Religion (optional): ______
Languages spoken, other than English: ______
Languages written, other than English: ______
Current Employment: ______Current Salary: ______
Most Recent Employment: ______Most Recent Salary: ______
Highest level of education completed (check one): High School University Graduate School
Dates of study: ______Name of School: ______
Dates of study: ______Name of School: ______
Subject studied / Degree earned: ______
______
Brief essay questions:
What interests you about conflict resolution & why do you want to become a mediator?
What skills do you have which you think would make you a good mediator?
NCRC is a community-based organization. What experience do you have volunteering in the community? What was the time commitment to that work?
What times during the week are you available to mediate? (Please remember that you need apx. 3-4 hrs per session)
Do you have any special dietary needs? (Meals and snacks will be provided throughout the training)
Training Fee:
NCRC offers several options for individuals seeking volunteer mediator experience and/or mediation training. Please select one option belowand mark the number of people registering beside the fee. (Example: mark a “1” in the “# Registering” column if you are applying individually; mark “2” if you are from an organization that seeks to register 2 employees, etc.)
# REGISTERING / FEE / DESCRIPTION$300 / 40 hours of mediation training with a commitment to provide 12 volunteer mediations for NCRC within 1 year
$200 / 30 hours of mediation training with a commitment to provide 12 volunteer mediations for NCRC within 1 year
*This option is for individuals who do not meet the requirements of the TN Supreme Court Rule 31, Sections 17(a) and (b)
$995 / 40 hours of mediation training with NO commitment to volunteer
Subsidized Fee / A select number of full and partial scholarships are available for individuals with an annual income of $30,000 or less. Contact Tamara Losel to apply for a scholarship: 615-291-6272
* Summary of TN Supreme Court Rule 31requirements to be listed as a Rule 31 Civil Mediator, from Sections 17(a) and (b): The applicant must have a graduate degree and four years of practical work experience, or a baccalaureate degree and six years of practical work experience. To read the full provisions for Rule 31, go to:
______X ______= ______
# REGISTERING Fee SUBTOTAL AMOUNT
Recession Discount: 10% discount for organizations sending 2 or more employees, or for individuals who have made an annual contribution to NCRC in 2009.
Check here if you are eligible for a discount, and calculate the discount below
______subtracted by 10% =______
SUBTOTAL AMOUNT TOTAL AMOUNT DUE
Application Timeline:
Space is limited to 20 participants per training. Participants who are not admitted to the Summer 2009 training may be put on a waiting list for Fall/Winter. Please follow the application timeline below:
- Application (pages 1-2) due May 31, 2009– application may be returned by fax (615-296-4336), email (), or regular post: NCRC, P.O. Box 110801, Nashville, TN 37222
- Notices of acceptance will be made on June 3, 2009
- Payment due in full on the first day of training, June 10, 2009
Check, cash or money order accepted
NCRC Community Mediation Training
Summer 2009
June 10, 12, 13, 26 & 27; September 11 & 12
[Keep this page for your records]
PART 1 – 30 hours
- Wednesday, June 10 – 5:30 – 9:30 p.m. SNACKS PROVIDED
Location: Bradley Arant Boult Cummings Law Firm in Music Row, 1600 Division Street, Suite 700, Nashville, TN 37203
- Friday, June 12 – 3:00 – 9:00 p.m. DINNER & SNACKS PROVIDED
Location: NCRC office in south Nashville, 4732 W. Longdale Drive, Nashville, TN 37211
- Saturday, June 13 – 8:30 a.m. – 6:00 p.m. LUNCH & SNACKS PROVIDED
Location: NCRC office
- Friday, June 26 – 3:00 – 9:00 p.m. DINNER & SNACKS PROVIDED
Location: NCRC office
- Saturday, June 27 – 8:30 a.m. – 6:00 p.m. LUNCH & SNACKS PROVIDED
Location: NCRC office
PART 2 – 10 additional“Bridge to Rule 31” hours (for those eligible for Rule 31 listing)
- Friday, September 11 – 5:00 – 9:00 p.m. DINNER & SNACKS PROVIDED
Location: NCRC office
- Saturday, September 12 – 8:30 a.m. – 6:00 p.m. LUNCH & SNACKS PROVIDED
Location: NCRC office
If you have any questions, please contact Tamara A. Losel before the deadline of May 31, 2009:
Tamara A. Losel
Executive Director
Nashville Conflict Resolution Center
615-291-6272 phone
615-296-4336 fax
Thank you for your interest in community mediation!
NCRC Community Mediation Training
Summer 2009
June 10, 12, 13, 26 & 27; September 11 & 12
TRAINER BIOGRAPHIES
Trainers: Laurie D. Jewett, Esq. and Tamara A. Losel
Laurie Jewett is an attorney admitted to practice in the State of Tennessee in 1980 following graduation from Vanderbilt University with an undergraduate degree in political science and psychology in 1977 and a law degree in 1980. Ms. Jewett has practiced law in Nashville for the last 29 years, and in 1997 was in one of the first classes to receive Rule 31 Training in Tennessee. Ms. Jewett has been Rule 31 Certified Mediator in Tennessee in both Civil and Family Law since 2002, and is also specifically trained in Domestic Violence, Employment, Health Care, Community and Victim Offender Mediation. In addition to her law and mediation practice, Ms. Jewett teaches paralegals at the only ABA approved program in Middle Tennessee, and sits on the bench part-time for Metropolitan Davidson County as a Magistrate. Ms. Jewett has served as the Vice-Chair for the Board of the Nashville Conflict Resolution Center for the last five years.
Tamara Losel is the Executive Director of the Nashville Conflict Resolution Center. Tamara has been working in non-profit organizations for more than a decade, building community through various fundraising, education, program management and administrative functions. Tamaraobtained her undergraduate degree in English Literature from Earlham College, and two Master’s degrees from Brandeis University in Coexistence and Conflict Resolution, and Near Eastern and Judaic Studies. Tamara received her Rule 31 Civil Mediation training at Lipscomb University, and recently attended advanced mediation training in Boston, MA at Mediation Works, Inc. Tamara also spent 2005-06 in Jerusalem, working in the peacebuilding and conflict resolution field. As current ED of NCRC, Tamara oversees the organization’s court and community-based mediation programs.
Guest Speakers:Ken Jackson, Nedra Huggins-Williams, Angie Fernandez, David McMillan
Ken Jackson, Esq. is a Nashville attorney who holds B.A. and J.D. degrees from Southern Methodist University, and a M.Div. from Vanderbilt Divinity School. He is a Rule 31 Mediator certified for Family, General Civil and Domestic Violence, is licensed to practice law in the states of Tennessee and Texas and is an approved arbitrator for the American Arbitration Association as well as NASD Regulation, Inc. Mr. Jackson has over 400 hours of training in the fields of mediation and arbitration, and is a recognized expert in the field of ethics for the practicing attorney, mediator and arbitrator. He both speaks and publishes often in his multiple fields of competency, and is also known locally for his accomplishments in the field of theatre arts. Mr. Jackson has served with distinction as a Board member of NCRC for many years and is active in both the Nashville and Tennessee Bar Associations.
Nedra Huggins-Williams, Ph.D. holds an undergraduate degree from Fisk University, two Masters Degrees and a Doctorate in Communications from the University of Utah in Salt Lake City. She is a Rule 31 Certified mediator, certified in both Family and General Civil Mediation. Dr. Huggins-Williams spent twenty years as a career foreign service officer with a specialty in international economic development, serving in Africa, Asia, Latin America and Eastern Europe. Dr. Huggins-Williams is an accomplished teacher with faculty appointments at the National Defense University in Washington, D.C. and the University of Maryland in College Park, MD. NCRC is privileged to have her as a Board member, and she serves on the Board of Big Brothers and Big Sisters in Middle Tennessee in addition to running an international consulting business.
Angie R. Fernandez, Esq. holds a Bachelor’s and a Master’s Degree from Western Kentucky and graduated from the Nashville School of Law in 1981. Ms. Fernandez is a Rule 31 Certified Mediator and has over 200 hours of training in mediation in the areas of General Civil Mediation, Family and Domestic Mediation, Domestic Violence, and Victim Offender Mediation. Ms. Fernandez is well known for her particular expertise as a trainer in cultural diversity and is a beloved teacher and local leader in the area of multi-cultural dynamics in community mediation. Ms. Fernandez is fluent in Spanish and has been instrumental in establishing bi-lingual mediation programs in both the civil and criminal courts of Davidson County. She has served with distinction on the Board of NCRC for several years.
David McMillan, Ph.D. holds a Bachelor's degree from Southwestern in Memphis, a Master's degree and a doctorate degree in Psychology from the George Peabody College for Teachers in Nashville. He has maintained a private practice in psychology in Nashville for the last 32 years andcurrently servesas an Adjunct Professor of Psychology in the School of Nursing of Vanderbilt. Dr. McMillan sits on the Board of NCRC and has been involved in the local mediation community in Nashville for years. The Board is grateful for his service and his interest in teaching given the well-known intersection between the disciplines of law and psychology in the practice of mediation.