Application For Mentor Status {ADR-4000}

FORM ADR-4000 - APPLICATION FOR MENTOR STATUS. This form is used by individuals seeking to become mentors for court-referred mediators in Virginia. Applicants must provide their general information, certification details, and the court levels for which they are requesting mentor status. They must also confirm completion of a certified 4-hour training course on mentoring and provide proof of mediation experience, including at least 10 cases and 30 hours of mediation at the relevant court levels. Additionally, applicants must demonstrate their understanding of mentor responsibilities in guiding and evaluating mentees. By signing, they certify that the information provided is accurate and that they will adhere to the Standards of Ethics and Professional Responsibility for Mediators. The completed form is submitted to the Office of the Executive Secretary, Supreme Court of Virginia. www.FormsWorkflow.com