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Get Application For Mediator Certification - United States District Court

Et forth in and prescribed by S.D. Fla. L.R. 16.2. Please print, type, or complete form electronically. Personal Information Last Name First Name Middle Initial Facsimile Number E-mail Address Firm / Mailing Address Telephone Number Are you presently a member in good standing of a State Bar or the Bar of the District of Columbia? Yes No Specify Bar Membership (State or D.C.): Specify Bar Number: What is the year you were admitted to the State Bar or the Bar of the District of Columbia.

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