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* 1. Name of the person who will attend.

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* 2. What is the name of your firm?

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* 3. What is your telephone number?

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* 4. What is your email address?

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* 5. Have you ever been involved in a mediation? If so, approximately how many times?

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* 6. Have you ever served as a mediator? If so, approximately how many times?

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* 7. Are you familiar with the Court's Pro Bono Mediation Program? If so, have you ever been involved in a pro bono mediation?

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* 8. What are your thoughts about the effectiveness of mediation?

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* 9. Do you have any questions regarding mediation?

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* 10. Do you have any suggestions regarding the Court's use of mediation?

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* 11. Are there other ways the Court should consider promoting the use of mediation?

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* 12. Are there any particular issues or concerns regarding mediation that you would like the panel to discuss?

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