APPLICATION FOR MEDIATION
With this application I agreed and decided to initiate a mediation procedure to resolve the described below dispute and it should be carried out by a mediator of the MEDIATION CENTER at THE ARBITRATION COURT at “EUROPEAN INSTITUTION FOR MEDIATION AND ARBITRATION” (EIMA)
PARTY
Name
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(Name, Surname, Family)
Address:………………………………………………………………………………………………………………………….
Phone :………………………………………………………………………………………………………………………
E-mail:………………………………………………………………………………………………………………………….
REPRESENTATIVE OF THE PARTY
Name
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(Name, Surname, Family)
Address:………………………………………………………………………………………………………………………….
Phone ::………………………………………………………………………………………………………………………
E-mail:………………………………………………………………………………………………………………………….
OBJECT AND DESCRIPTION OF THE DISPUTE:
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ASSESSMENT OF THE VALUE OF THE DISPUTE:
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SELECTION OF A MEDIATOR:
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APPLICATIONS:
Document for the paid registration fee according to the TARIFF OF CONCILIATION CHARGES AND EXPENSES OF THE ARBITRATION COURT at “EUROPEAN INSTITUTION FOR MEDIATION AND ARBITRATION” (EIMA)
2. Written documents on the basic facts of the dispute.
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3.Questionnaire sheet.
THE PARTY:
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(Name and Signature)
THE REPRESENTATIVE OF THE PARTY:
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(Name and Signature)
DATE: …………………….