Re-application for Certified Membership Certified Member Application v5.03.2022 Name * First Name last * Last Email * Confirm Email * I am applying to become an APFM: * Certified Advanced Practitioner Certified Practitioner I am currently an APFM member at the following level: * Advanced Practitioner Practitioner Only current APFM practitioner and advanced practitioner members may apply to become Certified members. Learn more about our membership categories. For Advanced Practitioners: I attest that I have met one or more of the following requirements (check all that apply): * 1) Mediated 100 or more divorce cases to completion (including developing an equitable distribution plan and a memorandum of understanding, or mediated marital settlement agreement). 2) Mediated 100 or more mixed types of family cases (e.g. divorce, parenting plans, elder disputes, post-divorce issue(s), court-connected custody/visitation, parent-child disputes). 3) Have a minimum of 500 or more total mediation session-hours. For Practitioners: I attest that I have met one or more of the following requirements (check all that apply): * 1) Mediated 20 or more divorce cases to completion (including developing an equitable distribution plan and a memorandum of understanding, or a mediated marital settlement agreement). 2) Mediated 20 or more mixed types of family cases (e.g. divorce, parenting plans, elder disputes, post-divorce issue(s), court-connected custody/visitation, parent-child disputes). 3) Have a minimum of 100 total mediation session-hours. Please provide the following information: Certificate of completion for 40-hour basic family mediation training with training in domestic violence. Certificates of completion for additional 40 hours of training or continuing education in family mediation. For Advanced Practitioner level only: Certificates of completion for additional 20 hours of training/practicum or continuing education in mediation practice skills. Proof of Malpractice Insurance **If certificates of completion are not available please provide a list of trainings and include the title, date, trainer, and number of hours. Upload the documents in the "Document(s) Upload" box below. Only PDFs and JPEGs are permitted. Maximum file size is 5MB. No more than 5 files may be uploaded. I attest that: * I have never lost a previously held license or certification in any field due to sanctions. I pledge: * to follow the APFM Ethical Standards for Professional Family Mediators. Document(s) Upload * Drop a file here or click to upload Choose File Maximum upload size: 5MB reCAPTCHA If you are human, leave this field blank. Submit Application
