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Download here your application form before filling out this form

I hereby apply for*
- Registration ADR full certified mediator
- Registration ADR associate certified mediator
- Accreditation ADR approved basic mediation training program
- Accreditation ADR approved continuing professional education (CPE) program
- Group Application request (minimum 25 people)
Organization / Company
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Initials*
M.I.
Name*
Academic degree / title
Address*
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Email*
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WCEI – INT ADR Register – Mediator Application Mediator form
Please ad a scanned copy of a completed and signed application form (Download the form at the top of this page) or Mail to: WCEI / EMCI / International ADR Register P.O. Box 5530 6802 EM Arnhem Netherlands
CV - Curriculum Vitae
Please ad a scanned copy of your CV or Mail to: WCEI / EMCI / International ADR Register P.O. Box 5530 6802 EM Arnhem Netherlands
Portfolio
Please add relevant copies of related certificates and valid memberships with other ADR organizations. Please ad a copy of a valid ID (Scan) or Mail to: WCEI / EMCI / International ADR Register P.O. Box 5530 6802 EM Arnhem Netherlands
How many people do you expect to have an interest to apply?*
Please enter a value greater than or equal to 25.
Additional information:
Copy of ID
Please ad a copy of a valid ID (Scan) or Mail to: WCEI / EMCI / International ADR Register P.O. Box 5530 6802 EM Arnhem Netherlands
Compliance Statement*
- You hereby apply to be an ADR certified mediator. You will receive by e-mail a fact sheet with an overview of delivered and missing documents. An online invoice will be send by e-mail.
1st year of registration: administration & certification costs € 250,00 (+19 % VAT) Annual registration costs (not in 1st year) € 97,50 (+19 % VAT)

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WCEI / EMCI / International ADR Register
P.O. Box 5530
6802 EM Arnhem
Netherlands

Tel:+31 (0)88 0038 777
+31 (0)6 5437 5167
+31 (0)6 4136 1907

International ADR Register is ISO 9001:2008 certified by Lloyds Register Netherlands. The ISO 9001:2008 certification is registered with DAR and UKAS. International ADR Register is the registered trade name and activity of WCEI.

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