Make check payable to: State of Minnesota
Processing time is usually 2-3 weeks and a confirmation letter will be sent after approval.
SECTION 1: GENERAL INFORMATION Organization Name:____________________________________________________
Daytime Phone: (_____)__________________ Fax: (_____)__________________
SECTION 2: PLACEMENT REQUEST Indicate the neutral roster(s) for which you are requesting placement. Also, indicate below the name of the individual from your organization who has applied or been approved for that roster.
NOTE: In order for your organization to be placed on a roster, at least one individual associated with your organization must be approved for that roster. You are required to have individual neutral roster application forms on file in your organization for each of your neutrals.
(Arbitration, Consensual Special Magistrate, Moderated Settlement Conference, Summary Jury Trial)
(Early Neutral Evaluation, Neutral Fact Finding)
SECTION 3: CIVIL LAW AREAS OF EXPERIENCE Indicate your areas of civil law experience for listing on the Minnesota Supreme Court website’s searchable roster (you must choose at least one).
Business/Commercial Personal Injury
Complex Litigation/Class Actions Professional Liability/ Malpractice
SECTION 4: FAMILY LAW AREAS OF EXPERIENCE Indicate your areas of family law experience for listing on the Minnesota Supreme Court website’s searchable roster (you must choose at least one).
Adoption Parenting Time/Child Visitation
Minn. Stat. § 518.1751, subd. 2(c) states that individuals who have completed the 40 hour family mediation training are eligible to serve as parenting time expeditors, subject to continuing education requirements. If you have completed the family training and would like to be listed on the Minnesota Supreme Court website as available for parenting time expediting, please check the following box. You should also contact the local court administrators if you would like to be on the county rosters pursuant to Minn. Stat. § 518.1751, subd. 2(b).
Parenting Time Expeditor
SECTION 5: COUNTY PREFERENCE Indicate those counties in which your organization is willing to provide ADR services:
All 87 counties All 7 metro counties (Anoka, Carver, Dakota, Hennepin, Ramsey, Scott, Washington)
The following individual counties: please circle
SECTION 6: SIGNATURE I do hereby certify that the information provided in this application is true, that only neutrals who qualify under Supreme Court Rules on Alternative Dispute Resolution will participate in this program, and that, upon request, I will provide, documentation of training provided to neutrals.