Forms

Application for NMAS accreditation (alternative pathways)

Prerequisites for NMAS accreditation

Do you have:

* Membership or employment with an organisation which has a relevant ethical code or standard and procedure for complaints and discipline

Yes

If you are not a member of a relevant organisation, you are ineligible to apply for NMAS accreditation. Resolution Institute offers coverage under our complaints handling mechanism as part of our Professional membership >>

* Relevant professional indemnity insurance or statutory immunity?

Yes

If you do not have insurance or immunity, you are ineligible to apply for NMAS accreditation. If you are a Professional or Fellow member with Resolution Institute please sign up to our member only policy >>

* Applicable good character references from two members of your community, or proof of good character from another scheme

Yes

If you do not have two good character references, you are ineligible to apply for NMAS accreditation. These can be given by any member of the public outside your family.

* Declaration of competency in a mediator skills assessment conducted by

Resolution Institute

Another provider

Neither

If you have a declaration of competency from neither of the above, you are ineligible to apply for NMAS accreditation. Resolution institute offers mediator skills assessment which you can register for here >>

* Appropriate mediation training through:

s2.5(a) Training with another provider

s2.5(b) Significant experience and education

s2.5(c) CALD knowledge and experience

None of the above

If none of the above, you are ineligible to apply for NMAS accreditation. Resolution Institute offers appropriate mediation training which you can register for here >>

Personal details

* Given name
* Family name
* Email address
* Address line 1

Address line 2

* Suburb
* State/region

* Postcode
* Country
* Preferred phone

Company name

Occupation

Languages spoken

Compliance Declaration

The National Standards require that applicants for national accreditation must comply with the Approval and Practice Standards, any relevant legislation, professional standards or other requirements that may relate to them. Applicants must also disclose any disqualifications, criminal conviction, impairments, or refusal, cancellation or suspension of NMAS accreditation (As detailed below).

I declare that:

I have never had a criminal conviction.

I do not have an impairment that could influence my capacity to discharge my obligations as a mediator in a competent, honest and professional manner.

I have never been refused NMAS accreditation or accreditation renewal or had my accreditation suspended or cancelled.

I comply with the NMAS Approval Standards and Practice Standards.

I accept that Resolution Institute as an RMAB, can disclose information about me to the MSB and the MSB can release that information to other RMABs upon request.

If any of the above remains unchecked, please provide disclosures and relevant information.

I declare that all the information provided in this form is, to the best of my knowledge, truthful and accurate.

* I confirm that I

Have filled this application form out myself to the best of my ability.

* Date: (dd/mm/yy)

Membership and MSB registration fee

As of 1 March 2012, the MSB introduced a registration fee of $100 (including GST) payable at the time of accreditation or re-accreditation and thereafter every two years on each successive re-accreditation. If you are a Professional or Fellow level member of Resolution Institute, no further fees apply. If, however, you are a member of another RMAB or a member or employee of an organisation with a relevant ethical code of conduct or standard and a complaints and disciplinary procedure that can address complaints against mediators, (e.g. Fair Work Ombudsman, Fair Work Commission) a further $88 administrative fee applies.

* I am a member of:

Resolution Institute at an appropriate level ($100)

Another compliant RMAB or organisation ($188)

If you are a member of another compliant RMAB or organisation, please provide proof of your membership in PDF form below.

Assessment

* Assessment provider:

I have been assessed as competent in a mediator skills assessment conducted by Resolution Institute (i.e a simulation recorded and assessed by independent assessors)

I have successfully completed a mediator skills assessment (in real time or recorded) conducted by a provider other than Resolution Institute

If you have been assessed by the Resolution Institute, please move to next page immediately.

If you have been assessed by another provider, please provide the name of the provider below:

Year of assessment (dd/mm/yy)

Details of simulated mediation assessment:

I declare that:

My assessment was at least 1.5 hours long

I was not provided coaching by an assessor during the simulated mediation.

To my knowledge, the assessor had no conflicts of interest with me.

The assessment form included assessment criteria that reflected the knowledge, skills and ethical principles articulated in the Practice Standards.

If you have not ticked any of the above boxes, you are ineligible for accreditation.

Please attach a copy of the mediation skills assessment below. This assessment must include:

- Written feedback on your performance.

- The extent to which you have met the assessment requirements.

- An indication of the assessment outcome.

Good Character

The National Standards specify that RMABs require mediators who apply to be accredited to provide evidence of ‘good character’. This may be achieved in two ways:

- Provision of two character references from members of the community who have known you for three or more years OR

- Satisfaction of the requirements of 'good character' under another system (e.g. Law Society Rules)

To access a good character reference template, please download a copy here >>

If applying with references, please attach below:

* Reference 1:

* Reference 2:

If you have already satisfied the requirements of 'good character' under another system, please enter the name of the organisation which conducted the 'good character' assessment below.

Please attach proof and details below.

Insurance:

The National Standards require that applicants for national accreditation provide the RMAB with evidence of their current status in respect of their professional indemnity insurance or have statutory immunity.

Note: Resolution Institute offers a competitively priced, combined professional indemnity and public liability insurance. To view and apply for the policy, please go to: www.resolution.institute/membership/type/pi-pl-insurance

Professional Indemnity insurance:

Name of insurance provider:

Policy Number:

Expiry date of policy:

Employment cover or statutory immunity:

Name/type of employment cover or immunity

Please include proof and details below:

Alternative Pathways

(i) Training with another provider:

NMAS requires that RMABs can only recognise training which fulfils the requirements of sections 2.3 or 2.5 of the Standards. If you do not seek accreditation under this pathway, please move to the next page.

I declare that:

The course was conducted by at least two trainers

The course had sufficient coaches for each trainee to be observed performing the role of mediator by different coaches in two simulated mediations each of at least 1.5 hours in duration

The course comprised at least 38 contact hours (this means teaching hours) which was conducted as a single course or in modules over a period of up to 24 months

The course contained at least nine simulated mediation sessions and in at least three simulations, I performed the role of mediator;

The course had coaches who to my knowledge, were accredited as mediators under the NMAS;

Coaches (described above) provided written feedback to trainees;

The course contains content that includes the knowledge, skills and ethical principles articulated in Part III of the Practice Standards (see Appendix 1 to this application form).

If any of the above remains unchecked, please provide disclosures and relevant information.

Name of course:

Name and contact details of provider:

Year of completion:

Please attach a copy of a certificate of completion of this training.

You have now completed all the requirements to apply for national accreditation. Please proceed to the end of the form and select 'Submit'.

Alternative Pathways

(ii) Experience and education

Under 2.5(b) of the standards accreditation can be given to those with significant experience. If you do not seek accreditation under this pathway please move to the next page.

I have conducted at least 100 hours of mediation in the past two years:

Yes

Please attach evidence in the form of a one page summary outlining how your experience meets this requirement below:

I have provided two references attesting to my competence as a mediator:

Yes

Please attach two references which comply with the "mediator competence reference" form. If you have not already done so, please download a copy here:

Reference 1:

Reference 2:

I have met the continuing accreditation requirements as referred to in section 3 of the Standards:

Yes

Please attach the "CPD eligibility" form. If you have not already done so, please download a copy here:

I have completed mediator training, supervision or education: (Resolution Institute will consider the length of training, experience and expertise of trainers and coaches, theoretical material relating to mediation, skills based practice and feedback received)

Yes

Please attach proof of training below:

You have now completed all the requirements to apply for national accreditation. Please proceed to the end of the form and select 'Submit'.

Alternative Pathways

(iii) CALD knowledge and experience

Under s2.5(c) of the standards, accreditation may be given to those who possess appropriate culturally specific mediation experience in the community with which they identify.

I possess appropriate mediation experience and knowledge of the unique values and traditions within the culturally and linguistically diverse (CALD) community with which I identify:

Yes

Please write cultural group below:

Please attach evidence below:

I have provided two references attesting to my competence as a mediator:

Yes

Please attach two references which comply with the "mediator competence reference" form. If you have not already done so, please download a copy here >>

Reference 1:

Reference 2:

Yes

Please attach proof of training below:

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