59 E 11th Ave, Suite 100
Eugene, OR 97401
Phone: 541-344-5366
Basic Mediation Training > Basic Training Registration


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REGISTRATION FORM

WHAT:   Mediator Basic Training

WHO:     Lead Trainer, Chip Coker

WHEN:   March 1-3 and 16-17    8:30am to 5:30pm     

WHERE:   CMS Training Center, 59 E. 11th Ave., Suite 100, Eugene, Oregon. (corner of Oak and 11th)

COST:  $600 if received on or before February 10 (see Late Registrations, below).  Price includes all materials, continental breakfasts, snacks and beverages .  You may bring your lunch, or eat out.

You must pre-register; no walk-ins will be permitted.  Space is limited to the first 24 paid registrants.

PAYMENT METHODS:  You may pay by cash, check or credit card.  If you wish to pay by check then please click on the Printer Friendly link above, print and fill out the form, and mail it in or drop it off with the proper payment amount to CMS, 59 E. 11th Avenue, Suite 100, Eugene, Oregon, 97401.  If you wish to pay by debit or credit card, you will have the opportunity to do so after you submit the electronic registration form below.

LATE REGISTRATIONS:  The cost of the training will be $700 if you pay after Feb. 10.

CANCELATIONS:  Full refund if you cancel on or before Feb. 17.  Fifty percent refund if you cancel after Feb.17 but on or before Feb. 24.  NO REFUND if you cancel after Feb. 24 or fail to be present on one or more of the training days.

VOLUNTEER REBATE:   50% of the cost of your training will be rebated to you if you volunteer 100 or more hours to CMS during the following two years (this works out to about 4 hours per month).  CMS has a wide variety of volunteer opportunities, including newsletter writing, website maintenance, mediation work, case development work, data entry and other office work, community outreach, fundraising projects and many others.  By volunteering, you will also have an opportunity to practice your new skills, network with other ADR professionals and be part of our efforts to reduce conflict and crime in our community.

PRIVACY POLICY:  Your privacy is important to us.  We will never sell or otherwise provide your contact information to any non-related third party.

Name
first last
Title
Company
Address
street line 1
street line 2
, city, state/prov zip
Email
Phone
Fax
Do you intend to participate in our rebate program by volunteering 100 hours to CMS during the following 2 years?
No
Yes
What is your occupation?
Does your occupation require annual continuing education?
No
Yes
How did you hear about our training?
Do you have any dietary, mobility, or other special needs?
No
Yes
If so, please identify them here:

Note: Please do not include any URLs in form.
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