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ASUM

Name:

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Email:

Phone Number:

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Date of Birth:

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Student ID:

Activity Fee Paid:

Yes

Please provide a brief summary of the conflict you hope to resolve with mediation.

The following questions pertain to all of the individuals who should participate in the mediation.

Name(s):

Email(s):

Phone Number(s):

Address(es):

Please attach any relevant supporting documents.

File size upload maximum is 16MB. File types allowed: pdf, doc, docx, xls, xlsx, csv, txt, rtf, html, zip, mp3, wma, mpg, flv, avi, jpg, jpeg, png, gif, psd, kmz

In order to obtain mediation services, you must be a student at the University of Montana and pay the activity fee each semester. After submitting the intake form, you will be notified as soon as possible on how we are able to assist you. If you are given an appointment, this does not guarantee that we are able to assist with mediation. Due to potential conflicts of interest, ASUM Legal Services cannot provide both mediation services and legal representation in the same or related matters. Mediators must remain neutral and able to keep confidential information obtained through mediation. If you meet with one of our attorneys seeking legal advice, you will not be able to use our mediation services for that matter. Similarly, if you use our mediation services, you will not be able to obtain legal advice or representation from our office regarding that matter. Please sign your understanding:

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