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ADR
 Northern District of California Neutral Profile

I am CURRENTLY:
I am APPLYING to be a (check one or more):
Name Firm or Office
First
Last
Name
Street
City
State/Zip
Phone E-mail/Website
Office
Fax
EMail
Website
Summarize ADR experience, particularly in the last five years
Other courts or organizations for which you serve as an ADR neutral
Number of sessions conducted as an ADR neutral
Mediation ENE Arbitration Other please specify(e.g., settlement conferences, judge pro tem
Course Provider, Course Content, Date and No. Hours Role-Playing by Participants
For each ADR panel to which you are applying, please check all subject areas in which you believe you are qualified to serve. Note that ENE and arbitration require greater substantive expertise than mediation because evaluators prepare evaluations and arbitrators render awards based on the merits of the case.
ENE Mediation Arbitration
Professional Experience: Summarize legal or other professional experience (including teaching), particularly in past five years
Nature of Practice: Attorney applicants only
Number of years in active litigation
Percentage of practice in last 5 years :
representing plaintiffs %
representing defendants %
in federal court %
in state court %
Bar Admissions
Bar Bar No. Year of Admission
No. District California N/A
California Bar
Other: Specify
Legal and Other Professional Education: Degree, school, year received
Other Relevant Information (e.g. publications, professional affiliations, awards, additional experience or skills)
Number of court cases per year for which you are willing to serve as a neutral: (the minimum is 3 per program)
Mediation Cases ENE Cases
Preference for type of cases you would like to be assigned:
Available for sessions in (check all that apply):
and/or
I consent to public disclosure, including on the court's internet site, of the information above.
(The court will post your profile only if you are an existing neutral or if you are accepted on an ADR panel.)
REFERENCES (List 3; if possible, include lawyers or parties in ADR sessions you conducted)
Name, phone no., context in which reference knows you
HAVE YOU EVER:
1) been part of any civil, criminal or administrative proceeding charging you with conduct involving dishonesty, unethical conduct or commission of a crime? or
2) been disciplined or cited for a breach of ethics or unprofessional conduct by any court, administrative agency, bar association, or other professional group, excluding sanctions in an amount less than $1,000, imposed against you in a civil proceeding?
If yes, please explain:
Use this area to provide any additional information:

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