AA White Dispute Resolution Center
Registration Form


Payment is due in full 30 days prior to the first day of training. Upon submitting your application, you will receive a notification that your application has been processed

Training Methods of Payment
Check, Cash, Purchase Order Credit Card**
40 Hour Basic Mediation Training $1,185.00 $1,215.00
Commercial Arbitration Training $1,925.00 $1,975.00
Dispute Resolution Seminar $70.00 $75.00

** Service Fee is included in the cost figure

Application Information

(This form cannot be submitted or printed unless all the requested information has been entered.)

Program title

40-Hour Basic Mediation Training

Commercial Arbitration Training (Domestic and International)

Dispute Resolution Seminar

Program start date
Please check one Mr.  Ms.  Mrs.  Dr.
Last name
First Name
Mail address 1
Mail address 2
Bus Telephone (xxx-xxx-xxxx)
Bus Fax (xxx-xxx-xxxx)
Email address
Home Telephone (xxx-xxx-xxxx)

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