Volunteer Mediator Application

The Westchester County Human Rights Commission occasionally requires the services of a mediator to help resolve discrimination matters. The mediator would engage with the complainant and respondent, as well as the staff of the Human Rights Commission. Mediation would take place in our office at 112 E. Post Road, 3rd floor, White Plains, NY.

If you are a certified mediator or an attorney and would like to inquire about a volunteer position, complete the form below.

Thank you for your interest and willingness to serve.

Complete the form below. The system will prompt you if an answer is required.

First Name*

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Last Name*

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City*

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Address*

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Phone*

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State*

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E-mail*

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If you are a trained or certified mediator, enter the name of the training or certifying agency.

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Contact phone number for this organization.

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Enter the date you completed your training or certification.

Enter date as mm/dd/yyyy.

Are you admitted to the NYS Bar?*

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If you are admitted, enter your attorney registration number.

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Do you prefer to mediate housing or employment matters?

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Approximately, how many cases have you mediated?

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List the types of cases you have previously mediated.

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Why are you interested in serving as a mediator for the Westchester County Human Rights Commission?

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List three references and their best contact information.

1: First Name

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Last Name

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Phone

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E-mail

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2: First Name

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Last Name

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Phone

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E-mail

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3: First Name

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Last Name

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Phone

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E-mail

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Do you have any time constraints that would impede your ability to mediate cases for the Westchester County Human Rights Commission?

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Solve the Captcha in order to submit the form.*

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