Request for Mediation

By requesting mediation I understand:

  1. The mediator is not providing any party with legal advice or understanding.
  2. The mediator is not providing counseling or therapy services.
  3. The mediation process may involve the mediator speaking privately to the parents and the school representatives.
  4. The mediator will work with all of the parties to help develop an agreement.
  5. Discussions during the mediation session will be confidential and may not be used during subsequent proceedings.
  6. I may not call the mediator as a witness in any further proceeding pertaining to the child’s case.
  7. The signed agreement may be shared with other educators working with the child.
  • Month / Day / Year
  • City, State
  • Month / Year
  • Financial Need Analysis for 2014-2015

    Every question in this section is required. If a line-item is not applicable to you, you must indicate N/A. Please use the July 1, 2014- June 30, 2015 time period.
  • If yes, please list your employer, your position, and the number of hours that you work per week on the resume that you are required to attach to this application.
  • Include alimony and any other sources.
  • Please itemize if needed.
  • Please total expenses for the above categories.
  • *Do not include funds derived from student loans.
  • *Do not include funds derived from student loans.
  • *Do not include funds derived from student loans.
  • Please include name and the amounts.
  • Please include law school scholarships AND scholarships from non-law school sources.
  • Questions Requiring Attachments

    All attachments must be PDF. This is the only acceptable format.
  • Accepted file types: pdf.
    This is optional but highly recommended.
  • Accepted file types: pdf.
    The general scholarship essay is required to complete your application. This essay should include any information the selection committee may find relevant along with detailing your academic accomplishments, interests, financial need, and community involvement. Please include your name, T# and 'General Scholarship Essay' at the top of your submission.