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2015-04-08 CC Packet
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2015-04-08 CC Packet
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Mediation Services File: <br /> for Anoka County <br /> Creating Peaceful Solutions <br /> Desire to Mediate Form <br /> Date: Name: <br /> Thank you for considering mediation as a path to resolving your issues! <br /> Mediation is a voluntary process that requires both parties to enter into a dialogue with a true desire to <br /> reach a mutually acceptable agreement. <br /> If you indeed desire to participate in mediation or if you do not wish to participate, please check the <br /> appropriate box and sign below. Either way, please mail this form back to our office in the enclosed <br /> envelope. <br /> 1-1 <br /> Yes I want to participate in mediation I do not wish to participate in mediation <br /> Please sign here: _ Please sign here: <br /> Date Signed: Date Signed: <br /> If checked below or on other side, please provide additional informatio <br /> Write a ArLef description of the issues you want mediated: <br /> Name, Address, or Phone Number of Other Party: <br /> --+ PLEASE TURN O VER AND COMPLETE OTHER SIDE—; <br /> Mediation Services for Anoka County is a community-focused 501(c)(3) nonprofit organization. <br /> 3200 Main Street NW, Suite 210, Coon Rapids, MN 55448 <br /> www.mediationservice.org office: 763-422-8El 00fax: 763-422-0808 info mediationservice.org <br />
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