The Association of South Florida Mediators and Arbitrators (ASFMA) | Fort Lauderdale Arbitrators

New Member

Renewal

First Name:

Last Name:

Address:

City:

State:

Zip:

Phone:

Fax:

E-mail:

Bus/Pers Web Addr:

Your ASFMA Membership includes the listing of your business or personal website on the ASFMA web page. Indicate if you would like us to list your website information.

Include information on website

Identify areas(s)and dates of certification for mediation and/or completion of training for arbitration by placing the information in the box to the right:

County:

Family:

Circuit:

Dependency:

Arbitrator:

Specialties:

Licenses/Degrees/Professions other than mediation/arbitration:

Are you willing to mentor a new mediator?

Yes

Please indicate if you have interest in the following:

Public Relations:

Membership:

Finance:

Programs:

Newsletter:

Social Events:

Arbitration:

Website:

Meeting Location Preference:

Broward Cnty:

Downtown Ft. Laud:

Miami Dade Cnty:

Palm Bch Cnty:

Signature:

Date:

Annual Dues: $60.00 Full Time Student: $30.00 (must attach copy of valid student ID)

Make check payable to Association of South Florida Mediators & Arbitrators, and mail to:

Broward Bar, Attn: Jane Goldberg
1051 SE 3rd Ave. Fort Lauderdale, FL 33316

2008 Association of South Florida Mediators and Arbitrators