Family Mediation Registration Form

Please complete this form, print it, and mail it with your deposit to hold your place in the training. Payment in full is due the first day of training. Class size is limited.

Name

Institute/Company

Mailing Adress

City

State/Province

Zip/Postal Code

Home Phone

Work/Cell Phone

Fax

Profession

Bar#

January 25-27, 2008 | February 8-10, 2008

Course fee for Family Mediation: $895.00
Make checks payable to UNM School of Law

Mail Registration Form and Check to:
UNM Mediation Training Coordinator
UNM School of Law
1 University of New Mexico
MSC11 6070
Albuquerque, NM 87131-0001