SelectADR.com New Profile Form

NOTE: This form is ONLY for new panelists. If you have a current profile, you may request a copy in Microsoft Word to be updated and resubmitted. Direct inquiries to dericson@mnbar.org. All fields in Part I are required to confirm current membership in the MSBA ADR Section. Profiles require approval by MSBA staff.

* Required

Part I. Required Member Data

All members must complete the six questions in Part I. They will be used to confirm your ADR Section membership and to identify you for our records.

Identification Number * Enter MSBA Member ID Number -OR- Attorney License Number. (If you are a non-attorney member of the ADR Section, type "Non-Attorney.")

First Name (Include Middle Name or Initial) *

Last Name *

E-Mail Address * (Required for confirmation; see checkbox in Part II to withhold from your online profile)

Choose One: *

I am an attorney member of the ADR Section
I am a nonattorney member of the ADR Section

Part II. Contact Information

Firm

Street Address

City

State

Zip Code

Phone Number

Fax Number

E-Mail Address

Include my e-mail address (entered above) in my profile
Withhold my e-mail address from my profile
Other:

Website

Part III. Photographs

A photograph will help make your profile stand out! Submit to the MSBA at dericson@mnbar.org. (You will be prompted again with an e-mail link after you submit this form.)

My Photo

I will submit a new/updated photo. (Watch for the link after you click "Submit.")
I do not wish to have a photograph on the site.

Part IV. ADR Type/Subject Matter

Help prospective clients find you! Select one or more checkboxes under each category.

Willing to Accept:

Pro Bono Cases
Reduced Fee Cases

Part V. Custom Profile

You may fill out any or all of the text box fields below. If you skip a field, it will not appear in your live profile.

ADR Services

Description of ADR Services

Primary ADR Services

Other ADR Services

Style

Personal Values

Willingness to Travel

Years of ADR Service

Professional Experience

ADR Training and Certification

Bars and Courts Admitted

Professional Affiliations and Association Memberships

Education

Other Qualifications

Keyword List (separate by commas)