Contact Resolver Application Form Name* First Last Your Email (required)* Enter Email Confirm Email Company/Chambers/PracticeAddress Street Address City State / Province / Region ZIP / Postal Code Phone no.Mobile no.Years of practice as a dispute resolver*Please enter a value between 0 and 50.Your area of specialist practice?*Specify your main area of dispute resolution practice. For example, family law or building adjudicationYour present Role:Select one only (required)*Accounting/FinanceAdvertising/Public RelationsAerospace/AviationArts/Entertainment/PublishingAutomotiveBankingClerical/AdministrativeConstruction/FacilitiesConsumer GoodsCustomer ServiceEducation/TrainingEnergy/UtilitiesEngineeringGovernmentMilitaryHealthcareHospitality/TravelHuman ResourcesInstallation/MaintenanceInsuranceInternetLaw Enforcement/SecurityLegal-BarristerLegal-SolicitorLegal-Corporate CounselManagement/ExecutiveManufacturing/OperationsMarketingNon-Profit/VolunteerPharmaceutical/BiotechProfessional ServicesQA/Quality ControlReal EstateRestaurant/Food ServiceRetailSalesScience/ResearchTechnologyTelecommunicationsTransportation/LogisticsOtherYour practice in Dispute Resolution:Choose any (required)* Lawyer Litigator Mediator Nationally Accredited Mediator Advisor Conciliator Commercial Negotiator Building Adjudicator Commercial Arbitrator International Arbitrator Investigator Expert Determiner Tribunal Member former Judge Your areas of Dispute Resolution experience:Choose any (required)*If an area of activity is not listed, record it in the area for additional information, below. Australian Consumer Law Commercial Resolutions Conflict Coach Family & Relationships Farm Debt Franchising Disputes International Dispute Resolution Mining Access Arbitrations Personal Injury Property Retail Leasing Employment Disputes Wills and Estates Workers Compensation Workplace Assessments Regions where you will provide ServicesIdentify here the regions where you are willing to offer dispute resolution services. This should be your home state and any additional areas in which you have an interest in practising.Select Other to indicate your local area or Town.Choose any (required)* NSW ACT Victoria Queensland South Australia Western Australia Northern Territory Tasmania Asia International Other (specify below) Additional Information:Add any further information here.Membership LevelPlease indicate your preferred Membership package*Monthly fees plus GST: Try It Out: $0 Professional Listing: $150 Market Your Practice: $350Try It OutProfessional ListingMarket Your PracticeSubmit your CVSend documents hereYou can attach your CV here as a .DOC or .PDF document.Accepted file types: doc, pdf, jpg.Yes/No*Accept the Terms & Conditions of your membership if confirmed. See here for details.YesNoPhoneThis field is for validation purposes and should be left unchanged. Office: Suite 602, 67 Castlereagh Street Sydney Phone: 02 9232 6000 Email: help@disputeresolvers.com.au