ADR Neutrals Application * Indicates Required Fields * Email * First Name * Last Name * Company Name * Address Line 1 Address Line 2 * City * State * ZIP * Country AustraliaAfghanistanAlbaniaAlgeriaAmerican SamoaArgentinaArubaAustraliaAustriaBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBermudaBoliviaBotswanaBrazilBrunei DarussalamBulgariaBurkina FasoCanadaCayman IslandsChileChinaColombiaCosta RicaCroatia (Hrvatska)CubaCyprusCzech RepublicDenmarkDominican RepublicEcuadorEqyptEstoniaFijiFinlandFranceGermanyGhanaGreeceGreenlandGuamGuatemalaHoly City (Vatican)HondurasHong KongHungaryIcelandIndonesiaIndiaIranIraqIrelandIsraelItalyJamaicaJapanJordanKazakhstanKenyaKorea, Democratic People’s Republic ofKorea, Republic ofKuwaitLatviaLebanonLiechtensteinLithuaniaLuxembourgMalawiMalaysiaMarshall IslandsMaliMaltaMauritiusMexicoMonacoMoroccoMozambiqueNamibiaNew ZealandNetherlandsNetherlands AntillesNicaraguaNigeriaNorfolk IslandNorwayOmanPakistanPalestinePanamaPapau New GuineaParaguayPeruPhilippinesPolandPortugalQatarRomaniaRussian FederationSaudi ArabiaSierra LeoneSingaporeSloveniaSlovakiaSouth AfricaSpainSri LankaSt Kitts and NevisSt LuciaSt Vincent and the GrenadinesSwedenSwitzerlandTaiwanThailandTrinidad and TobagoTurkeyUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayVenezuelaViet NamVirgin Islands (USA)YugoslaviaZimbabwe * Day Phone Fax Nationality Website URL Preferred Assignments Would you like to be considered for: Surrogate Arbitrator Surrogate Mediator Rates: Daily Rate Hourly Rate Prep Rate Minimums Travel Rate Education and Licenses Year College/University City/State Degree Specify any licenses, jurisdiction and date of licensure: (Include Bar Admissions for law and/or other professional licenses that apply; i.e., Architect, Engineer, etc.) Please spell out acronyms. License Year Issued State/Country Current (Y or N) Yes No Yes No Yes No Yes No Yes No Yes No Judicial Experience Please detail any judicial experience, starting with the most recent position first (in the top field) and working back. Dates of Service Court City/State Title Non-Judicial Work Experience Please detail your work experience, starting with the most recent job first and working back. Use the codes in the table below to describe your duties. Lawyer duties in this position (1) Litigator (law firm, government, public interest) (2) Partner (3) Associate (4) Managing Partner (5) Shareholder (6) Transactional attorney (7) In-house counsel in any capacity (8) General Counsel (9) Assoc. General Counsel (10) Arbitrator (11) Mediator (12) Law Professor: Full Time (13) Adjunct Professor (14) Other Non-lawyer duties in this position (15) Engineer: Civil Structural, Mechanical (16) Architect (17) Contractor (18) Sub-Contractor (19) President (20) Vice President (21) Director (22) Head Division (23) Corporate Business Person: (briefly identify division or department functions; e.g., Corporate Sales; Construction Management; Technology Development) (24) Other Dates of Service Company/Firm City/State Your Title Duties See categories above Primary Representaion P=Plaintiff D=Defendant Blank if not applicable P D P D P D P D P D P D ADR Neutral Experience Arbitration Overall Last 12 Months Total # Arbitrator Service # of total as Sole Arbitrator # of total as Tribunal Chair Mediation Overall Last 12 Months Total # Mediator Service Areas of Expertise Please indicate if you have a Primary Concentration (P) or a Sub-concentration (S) in each of the substantive areas below. Note – this chart refers to actual experience rather than areas of interest. * As lawyer, business person, advocate or judge but not as arbitrator or mediator. Substantive Area * Professional Concentration or Specialties Arbitrator Concentrations Mediator Concentrations Aviation P S P S P S Accounting and Auditing P S P S P S Antitrust P S P S P S Asbestos P S P S P S Banking P S P S P S Bankruptcy P S P S P S Class Action P S P S P S Copyright P S P S P S Construction P S P S P S Contract P S P S P S Entertainment P S P S P S Environmental P S P S P S False Advertising P S P S P S Financial Services P S P S P S FINRA P S P S P S Franchise P S P S P S Government Contracts P S P S P S Government Related Matters P S P S P S Healthcare P S P S P S Insurance P S P S P S Intellectual Property P S P S P S International Law P S P S P S International Disputes P S P S P S Labor and Employment P S P S P S Maritime P S P S P S Medical Devices P S P S P S Medical Malpractice P S P S P S Mergers & Acquisitions P S P S P S Oil & Gas P S P S P S Patent P S P S P S Personal Injury P S P S P S Pharmaceutical P S P S P S Product Liability P S P S P S Real Estate P S P S P S Reinsurance P S P S P S Securities P S P S P S Sports P S P S P S Taxation P S P S P S Technology P S P S P S Telecommunications P S P S P S Trademark P S P S P S Trade Secret P S P S P S Toxic Tort P S P S P S Trusts & Estates P S P S P S ADR Roster Listings Please indicate if you are currently listed as a neutral on the roster or panel of arbitrators maintained by any ADR organization, such as AAA, JAMS, CPR, ICC, etc. Organization Arbitration Roster Years on Roster Average Claim No. of cases Example: JAMS Banking 5 years $3.2 Million 3 Mediation Roster Listings Please indicate if you are currently listed as a neutral on the roster or panel of mediators maintained by any ADR organization, such as AAA, JAMS, CPR, ICC, etc. Organization Mediation Roster Years on Roster Average Claim No. of cases Example: CPR Construction 3 years $1.5 Million 2 Languages Please indicate any language ability below, aside from English. Note whether you are so fluent that you would be able to conduct an ADR proceeding in that language, or whether you have read only capability: Language Fluency Fluent Read Only Fluent Read Only Fluent Read Only Fluent Read Only Please upload a PDF of your resume or CV.