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Cream Abstract

MTMA Application for
Certified Mediator (CM)

PRIVACY NOTE.  The contents of this application will not be sold or distributed.  Successful applicants will have their name, contact information, and sector of practice published in the MTMA online directory.  A résumé may be submitted with this application.

APPLICATION INSTRUCTIONS: Please answer the following questions.  Incomplete applications will be returned for further information.  The Qualifications committee reviews all applications within 4 weeks.  If you have questions, or qualification obstacles, please contact MTMA at 406-519-8747 or


MEMBERSHIP DESCRIPTION.  A MTMA Certified Mediator (CM) is a mediator, neutral or individual dedicated to processes in which consensual and informed resolutions are made by parties.  CM's must meet MTMA's Certified Mediator Qualifications; subscribe to MTMA's Code of Ethics and Standards of Practice; be interested in furthering the purpose of MTMA; and be current in the payment of annual dues.

MEMBERSHIP DUES and APPLICATION FEES.  $125 per year plus a one-time $25 non-refundable application fee. The application fee is discounted to $15 for MTMA Associate members. The $10 discount will be applied to your first membership dues. MTMA's membership year is July 1-June 30. Application fee must be paid with your membership application. Application fees are non-refundable. You will be billed for membership dues.


Certified Mediator Qualifications

  • 40 hours training or equivalent

  • 8 hours observation

  • 8 hours co-mediation or supervised mediation OR

  • 8 hours solo mediation with 5 hours mentoring and consultation with a CM

  • 15 hours per year continuing education

  • Agree to follow the MTMA Code of Ethics and Standards of Practice

Before filling out this application please read the full list of qualifications at MTMA Certified Mediator Qualifications.

Part 1. Enter you contact information as you wish it to be listed in the membership director. All membership materials will be sent to this address.
The information below will not be included in the MTMA directory.
Are you curretly a MTMA AM and current on your membeship dues?
Do you want a MTMA website profile page? (+$60)
Part II. Practice Areas
List your area(s) of dispute resolution practice and the neutral role(s) you perform.
Part III (A) Training
List the training you have taken to enable you to perform as a neutral. Include sponsor and dates. Please enclose copies of certificates from your mediation trainings. A resume is not proof of training.
Part III (B) Writing Sample
MTMA Certified Mediators are required to have effective communication skills. Please attach a maximum of two double-spaced pages of your writing that demonstrates your effective written communication skills in drafting a mediated or other consensual agreement or memorandum.
Part III (C) Skills
Please indicate whether your training in basic mediation skills included:
Choose Skills
Part III (D) Experience
Please recount your number of case and hours spent in the following post mediation training activities. Enter whole numbers only.
1. Observation of Mediation & Other Neutral Processes
2. Co-Mediation or Supervised Medation of Mediation & Other Neutral Processes
3. Solo Mediation
4. Mentoring/Consultation
Part III (E) Reference (required)
List one reference (preferably a MTMA Member) who is familiar with your work and who may be contacted if additional information is required. Please include address and phone number.
Part IV. As a member of MTMA, I will subscribe to the purpose and principles of the Association. I will further certify the information supplied on this application is true, correct, and complete to the best of my knowledge.
Select an item ($)

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