Registration Form

The Mediation Process – Interest Based Mediation Training (40 Hours)* Cost: $575.00

  • April 20-24, 2015
  • July 13-17, 2015
  • October 5-9, 2015

Divorce and Child Custody Mediation Training (20 Hours)* Cost: $ 450.00

(Enrollment in this course requires completion of a basic mediation training class prior to attendance)

  • May 2-3, 2015
  • November 7-8, 2015

Advanced Mediation – Training for Experienced Mediators (8 Hours)* Cost: $ 175.00

  • May 23, 2015
  • November 14, 2015

* Course approved by the IMA, and WSBA and ISBA

Your contact information will be shared with the other participants in your seminar unless otherwise requested.

Name (for Certificate of Completion)

Profession/Occupation

Company

Address

City/State/Zip/Country

Work Phone Home Phone Fax

E-mail

To pay your Tuition Enclose Check Payable to: Fulcrum Institute Dispute Resolution Clinic

  • Full Tuition
  • Deposit - $50.00 non refundable

Register by mail or visit our web site & register today!

211 W. Augusta Avenue 2100 Northwest Boulevard, Ste 320

Spokane, Washington 99205 Coeur d’ Alene, Idaho 83814

Telephone: (509) 838-2799 Telephone: (208) 667-5325

Fax: (509) 838-5588 Fax: (208) 665-7958

www.fulcrumdispute.com