Fillable COLLIN COUNTY DISTRICT COURTS APPLICATION FOR MEDIATOR APPOINTMENT (Collin County Government)

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COLLIN COUNTY DISTRICT COURTS APPLICATION FOR MEDIATOR APPOINTMENT (Collin County Government)

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The COLLIN COUNTY DISTRICT COURTS APPLICATION FOR MEDIATOR APPOINTMENT (Collin County Government) form is 2 pages long and contains:

  • 1 signature
  • 12 check-boxes
  • 22 other fields

Country of origin: US
File type: PDF

U.S.A. forms for Collin County Government

BROWSE COLLIN COUNTY GOVERNMENT (TX) FORMS

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COLLIN COUNTY DISTRICT COURTS
APPLICATION FOR MEDIATOR APPOINTMENT LIST
Name: ________________________________________________________________________
E-mail address: _________________________________________________________________
Phone number: _________________________________________________________________
Mailing address: ________________________________________________________________
Rate information: _______________________________________________________________
I am fluent and mediate in these foreign languages: ____________________________________
I certify that:
I am a licensed attorney eligible to practice in Texas, bar #: ________________________
My primary office is in Collin County, I live in Collin County, or 80% of my practice is
in Collin County.
I want to be appointed to mediate the following types of cases:
_____ Family _____ CPS _____ Civil
At least 25% of my law practice is devoted to each of the practice areas checked above.
I have previously served as a mediator in at least 5 cases of each type checked above. (If
this box is not checked, please attach a letter describing your mediator experience.)
I have completed a mediator training course with at least 40 classroom hours of training
in dispute resolution techniques.
Date: ___________________________________________________________________
Institution/organization: ____________________________________________________
I have thoroughly read Tex. Civ. Prac. & Rem. Code Chapter 154, I understand my
duties, and I meet all of the qualifications.
I will follow the Ethical Guidelines for Mediators approved by the Texas Supreme Court.
For Family Law Mediations:
I have completed a mediator training course for disputes relating to the parent-
child relationship with an additional 24 hours of training in the fields of family
dynamics, child development, and family law. Date: _______________________
Institution/organization: ______________________________________________
I have completed at least 4 hours of family violence dynamics training developed
by a statewide family violence advocacy organization. Date: ________________
Institution/organization: ______________________________________________
I have thoroughly read Tex. Fam. Code §§ 6.602 and 153.0071.
For CPS Mediations: [you must also complete the application for CPS appointments]
I have completed a 20-hour training course specific to mediating child protective
services cases. Date: ________________________________________________
Institution/organization: ______________________________________________
DECLARATION
My name is ______________________________________, my date of birth is ____________ ,
and my address is ______________________________________________________________ .
I declare under penalty of perjury that the foregoing is true and correct.
Executed in Collin County, State of Texas, on this date: ________________________________
__________________________________________
Declarant signature
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COLLIN COUNTY DISTRICT COURTS APPLICATION FOR MEDIATOR APPOINTMENT (Collin County Government)

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Completed 17 July 2020

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