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1. Name of the person who will attend. (Required.)

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2. What is the name of your firm? (Required.)

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3. What is your telephone number? (Required.)

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4. What is your email address? (Required.)

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

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

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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? (Required.)

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8. What are your thoughts about the effectiveness of mediation? (Required.)

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9. Do you have any questions regarding mediation? (Required.)

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

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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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