Commercial panel Volunteer Application Form

Thank you for your interest in volunteering with Wandsworth Mediation Service (WMS).

We ask all prospective volunteers to complete the form below and attach your up to date CV, and certificate of your mediation training.

Please note that our mediators are expected to be available to take on 2-3 cases per year, although you can take on more if you wish.

As a Civil Mediation Council’s Registered mediation provider, we require all our workplace or commercial mediators to hold a membership with the CMC, either as an associate, registered mediator, or CMC fellow. Unfortunately, to comply with their policies, we can only include you on those panels if you have one of these memberships. You can find out more about the memberships here. Please note that mediators are responsible for covering the cost of their CMC membership.

All data submitted is governed by our Data Protection Policy and Privacy Notice for Mediators and Volunteers. By submitting personal information to us you agree to these terms.

1. Name*

First NameLast Name

2. Telephone*

3. Email*

example@example.com

4. Postal address*

Street Address

Street Address Line 2

City

Postal / Zip Code

5. Which of our panels are you interested in joining? (Please tick all that appropriate)*

Commercial Mediation PanelWorkplace Mediation Panel

6. Why are you interested in volunteering for WMS?*

7. Please set out any experience you have had of mediating, and any other qualifications you may have.*

8. What personal qualities and abilities would you bring to WMS? This may include any experience, qualification or achievement that might have a positive impact on your volunteering at WMS.*

9. WMS is committed to ensuring that all reasonable steps are taken to provide for the health and safety of our volunteers. Volunteers are also expected to take reasonable measures to safeguard their own health and safety. Please provide details below of any condition(s) that may restrict the range of tasks that you can undertake: *

10. How did you hear about Wandsworth Mediation Service?

Course title and provider*

Date of completion of course*

Date

I attach my training certificate*

YesNo

Please attach your training certificate

Please attach your CV

Professional Referee:

Name*

Telephone

Email or Address*

example@example.com

How Referee is known to you*

Personal Referee:

Name*

Telephone

Email or Address*

example@example.com

How Referee is known to you*

11. Criminal Convictions: Do you have any previous criminal convictions? Criminal records will be taken into account only when the conviction is relevant. Declaring a conviction will not prevent you from being considered for a volunteer role.*

YesNo

If yes, please give details below.

12. Please tick to confirm these:*

I confirm that, to the best of my knowledge, the information I have provided in this application is correct.I understand and agree that, as part of volunteering with WMS my details may be held in a confidential database that is only used for reasons relating to my volunteering. Details of our Data Protection Policy and Privacy Notice are on our website.

Signature*

Date*

Date

Commercial Mediation Panel, Volunteer Application Form

About you

Training

Referees

Declarations