Questionnaire for State and Local Mediation Organizations

1. Please provide the name and contact information for the liaison within your organization who would be the best person for us to follow up with.

Name: *

Email address: *

Phone number: *

Name of organization *

How would you like us to follow up with you?

Email

Phone

2. Approximate number of mediator-members within your organization: *

3. Do you have an annual conference? *

Yes

No

If so, when and where is the next conference scheduled?

4. Would you be interested in having APFM as a sponsor of your upcoming conference? *

Yes

No

N/A

5. Does your organization have a Listserv (group email list)? *

Yes

No

6. Which of the following services might be helpful to your organization and to your members? *

Access to conferences, seminars and workshops by nationally recognized mediators;

Access to continuing mediation education credits (legal, psych/social and general);

Access to webinars on topics of interest to practicing professional family mediators;

Expanding your membership/conference numbers from the attendance of our members;

Professional Mediator networking opportunities;

Initial 40-hour) mediator training;

Advanced mediator training;

Mediator certification;

Directing couples/families seeking mediation services to your organization/membership

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