Join the Approved Mediator Panel

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Thank you for your interest in the Beverly Hills Bar Association's Approved Mediator Panel (AMP). We look forward to receiving your application.

Please note that the BHBA AMP is not a mediator referral service or a training ground for new mediators. It is a panel of experienced mediators who are willing to offer superior services for a reasonable fee. Eligibility requirements for panel membership include a minimum of 30 hours of formal, basic mediation training and ongoing MCLE, and a minimum of 20 mediation sessions convened. If you have any questions about AMP panel membership, please submit them via email to: amp@bhba.org.
Full Name Full Name * First Middle Last
California State Bar Number
Maximum of 6 digits allowed. Currently Entered: 0 digits.
Email Address *
Phone Number Phone Number * - ### - ### ####
Company
Address Address *
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
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Undergraduate Degree(s) *

Dates received
School(s) conferring degree(s)
Graduate/Professional Degree(s) *

Dates received
School(s) conferring degree(s)
Languages (Other Than English) and Level of Fluency
Areas of Legal Practice/Specialization; Legal Certification(s) *

Firm(s) over the last 10 years
Nature of practice
Jurisdictions
Discipline by Bar
Experience as a Judge

Yes/No, If yes, then when and at which court?
Formal Mediation Training (Basic and Advanced Mediation Training/MCLE) *

Number of hours
Provider(s)
Dates by each provider
Membership/Service on Other Mediation Panels *

Which Panels?
Dates of Participation
Mediator Experience
Years of Service as a Mediator *
Number of Mediations conducted *
(Optional) Identify two or three challenging issues that arose during your mediations, describe what you did to address them, and specify the results of your efforts.
(Optional) Describe your most satisfying mediation
(Optional) How would the participants in your mediations describe you?
(Optional) Describe any experience handling cross-cultural issues in mediation
Mediation Rate(s) [Please note: AMP hourly fees are capped at a maximum of $400/hr.] *
Are you covered by Legal Malpractice Insurance? [Please note: AMP panel members are required to be covered by private malpractice insurance] *

Are you covered by Legal Malpractice Insurance? [Please note: AMP panel members are required to be covered by private malpractice insurance] Yes No
Carrier/Dates of Coverage: *
Do you agree to the terms of the AMP program? *

Do you agree to the terms of the AMP program? Yes No
Will you participate in a personal interview as part of the application process? *

Will you participate in a personal interview as part of the application process? Yes No
Will you commit to participating in a minimum of three continuing education hours regarding mediation each calendar year? *

Will you commit to participating in a minimum of three continuing education hours regarding mediation each calendar year? Yes No
Mediation References (Parties/Lawyers Who Have Participated in Mediation Sessions You Have Convened) *
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Join the Approved Mediator Panel

Join the Approved Mediator Panel

Mediator Experience