ADRBC Application for Membership

PART 1 - APPLICANT INFORMATION

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* 1. Legal First Name

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* 2. Legal Last Name

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* 3. Preferred First Name

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* 4. Contact Information

Street Address *

Unit or Apt #

City/Town *

Province *

Postal Code *

Email Address *

Phone Number *

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* 5. Employment Information

Profession *

Company *

If retired, profession prior to retirement

Part 2 - APPLICATION QUESTIONS:

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* 6. Are you interested in

Arbitration

Mediation

Both

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* 7. Are you currently practicing ADR?

Yes

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* 8. Are you interested in applying for Roster Status (if applicable)?

Yes

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* 9. Are you interested in our Education Programs?

Yes - As a Student

Yes - As a Coach or Trainer

All of the above

None of the above

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* 10. Would you be interested in participating in our Mentorship Program?

Yes - As a Mentee

Yes - As a Mentor

Not at this time

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* 11. If you answered 'Yes' and are interested in becoming a Mentor or Instructor, please include a brief resume of your credentials:

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* 12. Please share any other details regarding your interest in become a Member with ADRBC. We love hearing from you!

Part 3 - APPLICANT DECLARATION

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* 13. By filling in the boxes below, I agree, once accepted as a Member of ADRBC/ADRIC, to be bound by their by-laws and/or regulations made, the terms of their constitution and by any subsequent amendments and/or alterations thereto which may be made.

Applicant Initials

Date Submitted

Thank you for your interest in joining us at ADRBC/ADRIC.

A member of our staff will be reviewing your application, and will be in touch with you soon.
If you have not heard from anybody within 7-10 business days, please email us at: info@adrbc.com

If you haven't already done so, please consider subscribing to our Newsletter, where you will be among the first to know about upcoming events, courses, discounts and more!

With appreciation,
The ADRBC Team