Metropolitan Mediation Services

Application to Volunteer or to participate in MMS' Program of Supervised/Mentored Mediation Placements

Volunteer applicants:	Please begin by reading the information in the table below.
Supervised/Mentored Program applicants:	To read more about the program, click here. If you have already read about the program, click here to proceed with your application.

Setting	Case type	Frequency	Basic Qualifications
Massachusetts District and Boston Municipal Court	Small Claims	Weekly (Day and hour vary, depending on the specific court)	Completion of an approved training program and either a) experience in practice, or, b) participation in M.M.S.’ program of supervised placement.
	Evictions	Weekly on Thursday Mornings.	All of these case types require that a mediator has completed the above requirements PLUS specialized trainings, orientations, and mentoring conducted by M.M.S.
	Other Court (Civil, minor criminal, etc.)	Some courts call M.M.S. for mediation of specific cases. These are scheduled irregularly, on an "on call" basis.
Massachusetts Juvenile Courts. Mediation s are held at a variety of community locations convenient to the parties.	CHINS (Intra-family disputes involving adolescents and their parents/guardians)	Scheduled irregularly on an "on call" basis, often in the evenings.
Varied - usually mediated in M.M.S.’ offices.	Other conflicts referred by individuals, social service or government agencies.	Irregular (on call)	Qualifications depend on the specifics of an individual case.

SECTION 1: YOUR AREAS OF INTEREST

SECTION 2: Contact Info. SECTION 3: Your Training SECTION 4: Mentoring/Supervision SECTION 5: Oth. Experience Appl. Conclusion

SECTION 1:

YOUR VOLUNTEERING INTERESTS

This application is for either of two activities:

1) Mediators who have completed a satisfactory period of supervised or mentored practice and who wish to continue contributing to our communities as a volunteer, and

2) Those who have completed training and wish to enroll in MMS' Program of Supervised Mediation Placements. This latter program takes place in Small Claims Court only and requires a commitment of one half day per week for six months. For more information about this program, click here.

Which activity are you applying for?

Volunteer mediator (I have completed a period of supervised or mentored mediation practice)

Program of Supervised Mediation Practice (Weekly commitment to Small Claims Court for six months)

IF YOU CHOSE THE SECOND OPTION, PROGRAM OF SUPERVISED MEDIATION PRACTICE, SKIP TO SECTION 2, BELOW.

Which of the above type(s) of cases do you wish to volunteer for? (You can volunteer to mediate a case type even if you do not have specialized experience or training in that case type. MMS will provide specialized training, orientation, and supervision/mentoring when needed.)

Small Claims Evictions Other Court CHINS Other (non-court)

Ideally I would like to have opportunities to mediate, and my schedule would allow me to mediate:

Once or more a week.

Only once every two to three weeks.

Once a month.

Less than once a month.

My schedule allows scheduled weekly or monthly commitment with high reliability.

My schedule allows for mediations on an "on call" basis with one to two weeks notice.

I expect to be available as a volunteer for:

Non-mediation support services:

I would like to offer my services to Metropolitan Mediation Services in the following areas:

Database design/development Assistance to webmaster Volunteer coordination Office/Phone staffing

SECTION 2: YOUR CONTACT INFORMATION
SECTION 1: Your Interests SECTION 3: Your Training SECTION 4: Mentoring/Supervision SECTION 5: Oth. Experience Appl. Conclusion
First Name
Last Name
Organization
Street Address
Street Address (continued)
City	State Zip/Postal Code
Work Phone	Home Phone Mobile
Email	Fax

THE FOLLOWING SECTIONS SEEK INFORMATION SEPARATELY ABOUT YOUR TRAINING (SECTION 3), SUPERVISED/MENTORED PRACTICE (SECTION 4), AND OTHER EXPERIENCE (SECTION 5).

PLEASE READ THE FOLLOWING DEFINITIONS BEFORE CONTINUING:

Definitions Training (sect. 3) This involves attending a program in which you benefited from presentations, discussions, and exercises (including role plays) relating to learning practical mediation skills.

Supervised And/Or Mentored Mediation Practice (sect. 4) This refers to participation in a program where you conducted real mediations, not role plays, in a setting where you were observed and received feedback from a qualified supervising mediator. Both mediation time and debriefings and discussions related to specific mediations are considered part of the Supervised And/Or Mentored Mediation Practice, not mediation training.

Other Mediation Or Related Experience (sect. 5) This consists of mediation or related experience conducted relatively independently of an organized program of supervision or mentoring.

In the following sections, do not double report any activities as being part of more than one category.

SECTION 3: THIS SECTION RELATES TO YOUR MEDIATION TRAINING. THIS IS SEPARATE FROM ANY PARTICIPATION IN A PROGRAM OF SUPERVISED AND/OR MENTORED MEDIATION PRACTICE (SEE FOLLOWING SECTION).

SECTION 1: Your Interests   SECTION 2: Contact Info.   SECTION 4: Mentoring/Supervision   SECTION 5: Oth. Experience   Appl. Conclusion

SECTION 3:

Your

Mediation Training

I received my mediation training from Metropolitan Mediation Services

Approx. Date of Training: Month:   Year:

*** IF YOU WERE TRAINED BY METROPOLITAN MEDIATION SERVICES AND DO NOT WISH TO ENTER INFORMATION ABOUT ADDITIONAL TRAINING, YOU CAN SKIP THE REST OF THIS SECTION AND CONTINUE WITH SECTION 4, BELOW ***

I received mediation training outside of MMS. (You must submit completed training and mentoring certification forms)

Approx. Date of Training: Month:   Year:

My training was conducted by (Program or Organization)

The lead trainer(s) were:

Total number of training hours was: Less than 25 hours   25 - 29     30 - 40     Over 40

Is there a lead trainer we can contact to request a recommendation? Yes     No

If yes, please indicate trainer(s)'s name and phone number:

Additional comments about training:

SECTION 4: THESE QUESTIONS RELATE TO YOUR PARTICIPATION IN A PROGRAM OF SUPERVISED AND/OR MENTORED MEDIATION PRACTICE. THIS IS SEPARATE FROM YOUR TRAINING (PRECEDING SECTION) OR ANY UNSUPERVISED OR NON-MENTORED PRACTICE (SEE FOLLOWING SECTION).
IF THIS IS AN APPLICATION TO ENROLL IN MMS' PROGRAM OF SUPERVISED MEDIATION, THE FOLLOWING SECTIONS (4 AND 5) ARE OPTIONAL AND YOU CAN SKIP TO Application Conclusion.

SECTION 1: Your Interests   SECTION 2: Contact Info.   SECTION 3: Your Training   SECTION 5: Oth. Experience   Appl. Conclusion

SECTION 4:

Your

Mentored or

Supervised Experience

I received my mentoring/supervised experience from Metropolitan Mediation Services

Approx. End Date of mentoring/supervised experience: Month:   Year:

*** IF YOU COMPLETED YOUR SUPERVISED/MENTORED PRACTICE WITH METROPOLITAN MEDIATION SERVICES, YOU CAN SKIP THE REST OF THIS SECTION AND CONTINUE WITH SECTION 5, BELOW ***

I received mentoring/supervised experience outside of MMS. (You must submit completed training and mentoring certification forms)

Approx. End Date of mentoring/supervised experience: Month:   Year:

My mentoring/supervised experience was conducted by (Program or Organization)

The mentor(s)/supervisor(s) were:

Approx duration of mentoring/supervision:
mths

Approx total hours you OBSERVED mediations: hrs

Approx total hours you CO-MEDIATED: hrs

Approx total hours you MEDIATED SOLO:
hrs

SOLO hours observed by mentor/supervisor: hrs

Is there a supervisor/mentor we can contact to request a recommendation? Yes     No

If yes, please indicate supervisor/mentor(s)'s name and phone number:

Additional comments about supervision/mentoring:

SECTION 5: IN THIS SECTION, PLEASE DESCRIBE ANY OTHER MEDIATION OR RELATED EXPERIENCE YOU HAVE HAD.

SECTION 1: Your Interests   SECTION 2: Contact Info.   SECTION 3: Your Training   SECTION 4: Mentoring/Supervision   Appl. Conclusion

SECTION 5:

Your
Additional Experience

Program or organization:

Case Type(s)

Approx hours: Co-Mediated hrs.     Mediated Solohrs.

Comment:

Program or organization:

Case Type(s)

Approx hours: Co-Mediated hrs.     Mediated Solohrs.

Comment:

APPICATION CONCLUSION: DO NOT USE DOUBLE QUOTES (") ANYWHERE ON THIS FORM!

SECTION 1: Your Interests SECTION 2: Contact Info. SECTION 3: Your Training SECTION 4: Mentoring/Supervision SECTION 5: Oth. Experience

How did you learn about Metropolitan Mediation Services?

Please provide details for how you learned about us (Specific web site, ad source, email etc.)

Questions or comments about our programs, about our procedures, about this web site, or about anything else.

If you have questions, contact MMS Director Joshua Jacks, at 617-241-0300 or click here to send an email.

Definitions	Training (sect. 3)	This involves attending a program in which you benefited from presentations, discussions, and exercises (including role plays) relating to learning practical mediation skills.
	Supervised And/Or Mentored Mediation Practice (sect. 4)	This refers to participation in a program where you conducted real mediations, not role plays, in a setting where you were observed and received feedback from a qualified supervising mediator. Both mediation time and debriefings and discussions related to specific mediations are considered part of the Supervised And/Or Mentored Mediation Practice, not mediation training.
	Other Mediation Or Related Experience (sect. 5)	This consists of mediation or related experience conducted relatively independently of an organized program of supervision or mentoring.
In the following sections, do not double report any activities as being part of more than one category.

SECTION 4: THESE QUESTIONS RELATE TO YOUR PARTICIPATION IN A PROGRAM OF SUPERVISED AND/OR MENTORED MEDIATION PRACTICE. THIS IS SEPARATE FROM YOUR TRAINING (PRECEDING SECTION) OR ANY UNSUPERVISED OR NON-MENTORED PRACTICE (SEE FOLLOWING SECTION). IF THIS IS AN APPLICATION TO ENROLL IN MMS' PROGRAM OF SUPERVISED MEDIATION, THE FOLLOWING SECTIONS (4 AND 5) ARE OPTIONAL AND YOU CAN SKIP TO Application Conclusion.
SECTION 1: Your Interests SECTION 2: Contact Info. SECTION 3: Your Training SECTION 5: Oth. Experience Appl. Conclusion
SECTION 4: Your Mentored or Supervised Experience	I received my mentoring/supervised experience from Metropolitan Mediation Services Approx. End Date of mentoring/supervised experience: Month: Year: * IF YOU COMPLETED YOUR SUPERVISED/MENTORED PRACTICE WITH METROPOLITAN MEDIATION SERVICES, YOU CAN SKIP THE REST OF THIS SECTION AND CONTINUE WITH SECTION 5, BELOW * I received mentoring/supervised experience outside of MMS. (You must submit completed training and mentoring certification forms) Approx. End Date of mentoring/supervised experience: Month: Year: My mentoring/supervised experience was conducted by (Program or Organization) The mentor(s)/supervisor(s) were:
	Approx duration of mentoring/supervision:	mths
	Approx total hours you OBSERVED mediations:	hrs
	Approx total hours you CO-MEDIATED:	hrs
	Approx total hours you MEDIATED SOLO:	hrs
	SOLO hours observed by mentor/supervisor:	hrs
	Is there a supervisor/mentor we can contact to request a recommendation? Yes No If yes, please indicate supervisor/mentor(s)'s name and phone number: Additional comments about supervision/mentoring: