If you require any assistance completing this form, please call 0131 556 1221 or email firstname.lastname@example.org.
You can fill in the form online or download a version in Word format.
Upon receipt of your completed form, an invoice will be generated and sent to the email address that you have provided. The information that you provide will be used to update your records within our system and, for those organisations registering mediators will also be reflected on our website in the Find A Mediator section.
If you wish to pay your membership at the same time as submitting your application form please either include a cheque payable to the Scottish Mediation Network or make payment by bank transfer to the account number: 10272164, sort code: 80-46-38.