NOTE: Print a copy of this completed form for your records prior to submitting it electronically. This form must be taken along with payment to the Cashier's Office with the following codes: DEPT Code: 03450002 OBJECT: 738801.

PID:

Training Date:

Address:

City:

State:

ZIP:

Work Phone:

Home Phone:

E-mail:

UCF Student

Freshman 

Sophomore

Junior

Senior

UCF Graduate Student

UCF Faculty

UCF Staff

Non-UCF Participant (i.e. alumni and/or not currently enrolled UCF Students)

Department:

Have you had any previous mediation training?

No

Yes (If yes, please provide details)

Have you had any previous mediation experience?

No

Yes (If yes, please provide details)

 

***PLEASE NOTE: The DRS First Timer's Mediation Training is a basic training in conflict management skills and mediation techniques.  Participants do not need to have any prior mediation training or experience to participate in the training.  Participants must complete all 2 days of training to receive credit for completion of the training course.

***PAYMENT OF FEES:  All fees (as applicable) are non-refundable and are due one week prior to the first day of the training. There is no cost for UCF students, $25 for UCF Faculty/Staff, and $35 for non-UCF participants. For UCF Faculty/Staff that would like to make payment via an ID Transfer, please notify our office and provide a receipt as proof of payment. For all others, please make payment at the UCF Cashier's Office located on the first floor of Millican Hall.  * Contact our office for additional regional campus Cashier Office locations. When making payment, please provide your name and the following information to ensure that payment is deposited into the proper account:  DEPT CODE: 03450002 OBJECT: 738801

***The above rates are effective on September 22, 2006, at 12:00 PM. Registration forms received prior to this date and time will be charged the previous rates.

Please fax a copy of the receipt one week prior to the day of training. If you have any questions about this procedure, please contact this office via phone (407-823-3477) or e-mail before making payment.

Click here for RSVP deadlines - Year 2006 - 2007

If you have any questions regarding the registration process, please e-mail: spfarris@mail.ucf.edu