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Henning Mediation & Arbitration Service, Inc. 

  Training Registration Form 

 
 
 
 
 

 

 
  
 
  
  
  
  
 
 
 
 
 
 
 
  

	
    

      
Please complete the registration form below. Any information you provide will be used solely for the purpose of fulfilling your registration. Please see our Privacy Policy. 

    

    

      
*Full Name

      
    

    

      
Title

      
    

    

      
Bar#

      
        (required for CLE credits)
    

    

      
Company/Firm

      
    

    

      
Address1

      
    

    

      
Suite or Apt

      
    

    

      
City

      
    

    

      
State

      
    

    

      
Zip

      
    

    

      
*Phone

      
    

    

      
Fax

      
    

    

      
*Email

      
    

    

       
      * required fields
    

  

  

    
    

      Select Course, Date and CLE Option 
    

    

       
Select Course

      
Select Dates

      
Tuition $

      
CLE
Credit $

      
Obtain CLE Credit?

    

    
    

      
        
        Civil Mediation **
       
        
        
        
        
        
       
      
      
$820 

      
$150

      
      

        
      

    

    
 

    
    
    
    

      Mediation Practicum
      
        
        
        
        
      
      
$295 

      
$60

      

          
      

    

    

      Arbitration **
      
        
        
        
        
        
      
      
$325 

      
$50

      

          
      

    

    

      
Divorce Mediation **

      
        
        
        
        
        
      
      
$1220 

      
$150

      

        
      

    

    

      
Divorce Practicum

      
        
        
        
        
        
      
      
$325 

      
$60

      

        
       

    

    
    

      
      
**Includes $25 Georgia Office of Dispute Resolution Training Fee

    

       

      
Total Fee  $ 
          

    

  

  
  

    

      
Method of

      Payment
          

      		
      Registration is not complete until payment is processed.
    

    

      
        
        

           
          Check

      
        
Please print this registration form and mail, with your check to:

        

  Henning Mediation & Arbitration Service, Inc. 

          3350 Riverwood Parkway, Suite 75 

          Atlanta, GA 30339 

        		
    

    

      

          
            Credit Card

      

          
          

            
             
            
            

              
              

              
              

              
              

              
            
            		
          

          

            
              
                
              

                          
                

             
            
          

          

            
                  
                      
                        

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Additional Comments : 

        
Please add any comments or questions about your registration.

    

    

      

        

    

    

      These training courses have been approved for CLE credit in Georgia and by the Georgia Office of Dispute Resolution. The fact that a training program has been approved by the Georgia Office of Dispute Resolution does not imply that any particular court-annexed or court referred program must or will accept as neutrals those who have completed that program.
    

    

      Cancellation Policy: If notice of cancellation is given 10 days in advance of the scheduled training your payment will be refunded. No refund will be given for cancellations occurring within 10 days of the training, but you may reschedule to another training date at no additional charge, as long as you notify us no later than the day prior to the training date that you will be unable to attend. 
    

  

 
   
 
   

  

 
    
    

     
            
    
  









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