Civil & Commercial Mediator Training Programme

Civil & Commercial Mediator Training Programme

24-28 November 2014

Application Form

Please complete all parts of this form in black ink or by typing it. Incomplete forms will not be accepted.

1. Background Information

1.1 Personal details

Family name/surname in English

First name (English)


Gender – male/female

Country of residence

1.2 Passport details

Passport number

Issue date (dd/mm/yyyy)

Expiry date (dd/mm/yyyy)

Place of issue of passport

1.3 Contact details

Home address


Postcode/Zip code


Email address

Telephone number

(with international code)

Mobile number with

(international code)

2. Legal Qualification

Date of qualification as a lawyer

Number of years since qualification

3. Current Employment

Please be aware that one of the conditions of application is that you work for a Russian law firm

Job title

Law firm Civil & Commercial Mediator Training Programme name

Law firm address

Number of qualified lawyers working at law firm

3.1 Please describe your current job and legal specialisms

3.2 Please indicate what percentage of your work is international and involves disputes resolution on a scale of 1 to 100%

International work (1-100%)

Dispute resolution (1-100%)

3.3 Please provide a brief describe of the core work of your law firm

4. English Language Skills

4.1 Have you achieved a 6.5 in the IELTS?q yes q no

If no, please detail what equivalent English Language qualification you have achieved (and include the certificate with your application)

4.2 How often do you use the English language for the following activities?

To read documentsq regularly Civil & Commercial Mediator Training Programme q occasionally q never

To draft contracts/legal documentsq regularly q occasionally q never

On the telephone/in meetings with clientsq regularly q occasionally q never

5. Modules

Which modules do you choose q UK qualification

q UK/USA qualification

q Russian qualification

6. Declaration

I confirm that the information I have provided is correct and that I understand the terms and conditions of the programme, as detailed in the guidance document



7. Application submission instructions

Please email scanned or electronic copies of the following documents to by Friday, August 15, 2014

} Completed application form

} Main page of passport

For more information and details on how to apply, please contact us via Civil & Commercial Mediator Training Programme email or call +7 (495) 7434847

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Документ Civil & Commercial Mediator Training Programme