MediatorConsultant
Agreement to Mediate is made on_____/____/_____/
between the followin listed participants.
Client(s) Name:________________________________________________________________________
Client(s) Signature:_____________________________________________________________________
Client(s) Name:________________________________________________________________________
Client(s) Signature:_____________________________________________________________________
Client(s) Name:________________________________________________________________________
Client(s) Signature:_____________________________________________________________________
Co-Mediator(s) Name:__________________________________________________________________
Co-Mediator(s) Signature:_______________________________________________________________
Mediator(s) Name:_____________________________________________________________________
Mediator(s) Signature:__________________________________________________________________
Mediatorconsultant:
Charlie Williams MediatorConsultant
8345 Glenoaks Boulevard, Unit 6
Sun Valley, California 91352-3511
Phone number: 213-8194097 or 818-9513663
Fax number: 818-951-3663