Please Register Your Campus
Mediation/Conflict Resolution Program

Thank you for taking the time to help build our directory of new and existing campus mediation projects. Your information and comments are very helpful to our continuing efforts to document the growth and development of mediation on college campuses, and to provide useful supporting materials. If you would like to check our database of programs prior to registering yours (in case someone else has already registered you), please go to our Searchable Database (will open in a new window).

                         Program Registration Form

Note: Required fields are indicated by the symbol.

Name of Institution:
Is this a Public or Private Institution?:	Public  or  Private
College or University Enrollment:	Don't know/NA Less than 1000 students 1,001-5,000 5,001-10,000 10,001-15,000 15,001-20,000 More than 20,000 (Best guess is fine...)
Name of Mediation Project:
Institutional Division your project is under (ie residential life, student affairs, human resources, etc.):
Primary Contact Person:
What is the Primary Contact Person's title or role with respect to the project?
Mailing address:
City
State / Province:
Contact's Phone #:
Fax #:
Contact's Email address:
Program's Web Site:
What year did the program first offer mediation services?:
Please indicate the types of conflict resolution services your program offers (i.e. mediation, group facilitation, training, etc.):
Population served (i.e. students, staff, faculty, community, etc.):
Who provides the actual intervention services (i.e. student or staff volunteers, paid staff, etc.)?

Thank you for taking the time to share your information with us.
Use the buttons below to submit your registration