CJAM 40-hr Basic Mediation & Restorative Justice Training Application Form
Thank you for applying to attend our 40-hour virtual training. Once your application is reviewed, we will contact you with additional details. If you have questions, please contact us at training@cjamcenter.org or call 812-336-8677.

The cost of the training is $300. (Early Bird: $260 by December 31, 2021 ; $275 by January 17 , 2022). You may pay through our website, www.cjamcenter.org or
Mail a check to CJAM, 205 S. Walnut, Suite 16, Bloomington, IN 47404
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Date *
First Name *
Last Name *
Email *
Address (Street,City,State,Zip) *
Phone Number *
D.O.B. *
Gender Identity/Expression
If Applicable: Occupation & Employer (if student, please list school/major and indicate anticipated graduation date.)
How did you hear about this training? *
How long do you plan to be in the Bloomington area? *
Have you had previous conflict resolution training *
If yes, please describe previous mediation/conflict resolution training.
For which training are you applying? *
Reason for attending training:
Any additional comments, including any accommodation needs we should :
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