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Registration
Note: You will be redirected to the payment page after submitting your application.
First Name
Last Name
Email
Street address
Street address line 2
City
State
Zip code
Cell Phone
Work Phone
Website
Would you like information about any of the following committees?
Conflict Resolution Day Committee
Program Committee
Family Program Committee
Family Court Committee
Membership Committee
Social Media/Technology Committee
Nominating/Annual Meeting Committee
Community Mediation Committee
Outer County Outreach Committee
Would you like to be listed on the Directory of Mediators on the MCWP Website?
*
Yes
No
Please select your membership category
*
Individual on or before February 28th: $85
Individual after March 1st: $100
Corporate/organizational: $200 (Allows up to four (4) registered participants and one (1) membership vote)
Affiliate (volunteer mediator or mediation supporter): $25
Student: $10
Newly-Trained Mediator: FREE (if you had your first mediation training in the last 12 months)
How would you like to pay your dues?
*
Paypal (STRONGLY preferred)
By check made payable to MCWP. Please mail to: PO Box 23698
I am a new JMP mediator and my dues are free
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