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Renewing your AMDRAS accreditation – form

Renewal Application as an Accredited Mediator under AMDRAS

This renewal is undertaken in accordance with the AMDRAS Standards. Please refer to AMDRAS

Renewing Your AMDRAS Accreditation

First Name

Last Name

Address

City

State

Postcode

Mobile

Renewal Date

What is your current level of accreditation?

Accredited Mediator

Advanced Mediator

Leading Mediator

Honorary Leading Mediator

Do you currently hold a specialisation? If so, select from the approved specialisations list.

Are you renewing at the same level of accreditation? (See AMDRAS Clause 45)

Yes

If no, what level of accreditation are you applying for?

Insurance

Professional Indemnity Insurance or Statutory Immunity commensurate with your level of accreditation is mandatory for Nationally Accredited Mediators, AMDRAS. AMDRAS Clause 43

Are you covered by relevant professional indemnity insurance or have statutory immunity? (See AMDRAS Clause 43) (if YES, please attach your Certificate of Currency or other evidence of insurance cover).

Yes

Attach Your Certificate of Currency or Other Evidence of Insurance Cover

Choose File

If No, please provide more information

What is your insurance renewal date?

Practice Hours

Note 1: You should maintain a record of your practice hours, and this can be requested by our RAP or by the AMDRAS Board.

Note 2: Practice can include up to 5 hours of intake and preparatory work to set up the dispute resolution process, as well as up to 5 hours of observing a more experienced practitioner.

How many hours of dispute resolution-related practice have you facilitated as a mediator, co-mediator or third-party dispute resolver in the 24 months since your last renewal? (See AMDRAS Clause 46(c) and Appendix 1)

< 10 hours

10 to < 20 hour

20 to < 40 hours

+40 hours

If you are a Specialist Dispute Resolution Practitioner, have you met the requirement of at least 40 hours of dispute resolution practice with at least 25% being within your area of specialised practice?

Yes

Continuing Professional Development

Note: You should maintain a record of your CPD hours, and this can be requested by our organization or by the AMDRAS Board.

Have you kept a CPD record and met the requirements of 25 hours over two years of CPD directed at developing or maintaining the Professional Attributes? (See AMDRAS Clause 47 and Appendix 2).

< 25 Hours

+25 Hours

Please attach a copy of your CPD Record.

Choose File

Are you applying for Adjusted Renewal Requirements?

If you have not met the Practice or CPD requirements on what basis are you applying for adjusted renewal requirements? (See AMDRAS Clause 48 )

Lack of work Opportunities

Health or career circumstances

Residence in a non-urban area

Other barriers, including socio-cultural, to

Accessibility or Inclusion

Parental leave

Leave due to family circumstances

Other matters considered relevant

Adjustments sought (See AMDRAS Clause 48c)

Choose File

Office Use

Has the Registered Practitioner sought adjusted renewals previously?
Note: Adjusted renewal can not be approved for more than 2 consecutive periods under clause 48(e)
Indicate the adjusted renewal application outcome, including any conditions the RAP considers appropriate. (See AMDRAS Clause 48 and 49).

Approved?

Yes

Good Character & Disclosure

(a) Have you at any time been disqualified from any professional practice? (See AMDRAS Clause 38(c)(i)) (if YES, please attach a detailed statement and explanation).

Yes